Marian Flinchbaugh wrote about a 31 y.o. mom with a two month old
breastfeeding baby who is having pain from endometriosis and looking for a
solution.  The physician had recommended hormonal treatment and
discontinuing breastfeeding.  I wonder if the possibility of using
progestin-only oral contraceptives has been explored.  According to Hatcher
in "Contraceptive Technology" (16th ed), progestin-only OC's (also
Depo-Provera and Norplant) are all indicated in the use of management of
pain from endometriosis.  It seems like the progestin-only pills might be
worth a try since they are not incompatible with breastfeeding and can be
discontinued immediately if the mom doesn't find them effective or has
really objectionable side-effects.  In my clinical site in Oregon where I
just completed my nurse-midwifery training, we used progestin-only pills
very frequently for contraception in breastfeeding moms without any problems.