Halsey and Endometriosis: What They've Said About Medication, Treatment, and Living With the Disease

What Halsey Has Actually Said About Endometriosis

Halsey has been one of the most visible public figures to name endometriosis plainly, in their own words, across multiple interviews and social media posts. In 2016, Halsey posted on Twitter acknowledging a diagnosis of endometriosis and describing how it had affected their menstrual cycles and their fear about future fertility. That moment of disclosure was significant not because celebrities get sick (they do), but because endometriosis is a condition that affects roughly 10% of women and people assigned female at birth during their reproductive years, yet consistently goes unrecognized for years.

Be clear about what this article is and is not doing. Halsey's specific medication regimen is not publicly confirmed in detail. What they have described, across a Rolling Stone cover interview, an Instagram post in 2022, and multiple public appearances, is the emotional and physical weight of the disease, the decision to freeze eggs, and the reality of managing a chronic condition while working. Where the article draws clinical inference from those statements, it labels that inference.

The 2022 Fertility Disclosure

In 2022, Halsey announced on Instagram that they had been diagnosed with T-cell lymphoblastic lymphoma and described undergoing egg freezing before starting chemotherapy. This was not their first discussion of egg freezing. Earlier interviews had referenced the procedure in the context of endometriosis-related fertility concerns, a choice that reflects a documented clinical reality: endometriosis can reduce ovarian reserve over time, and women with the disease who wish to conceive are often counseled to consider fertility preservation.

What They Have Not Confirmed

Halsey has not, in any publicly available interview or post, named a specific medication for endometriosis by drug name. Any content suggesting otherwise is inference or fabrication. This article will not name a drug as "Halsey's medication." What it will do is explain the medical field that fits the history they have described.

Why Endometriosis Is Specifically a Women's Health Crisis

Endometriosis grows endometrial-like tissue outside the uterus. It causes pelvic pain, heavy and irregular bleeding, painful intercourse, bowel and bladder symptoms, and in a significant proportion of patients, subfertility. The ASRM classifies endometriosis in four stages (I through IV) based on the extent of implants and adhesions, though stage correlates poorly with pain severity.

The average diagnostic delay is 7 to 10 years from first symptom to confirmed diagnosis. That delay exists because period pain is normalized, because many clinicians still dismiss dysmenorrhea, and because definitive diagnosis requires laparoscopy. During those lost years, the disease progresses, adhesions form, and ovarian reserve may decline.

How Endometriosis Changes Across Life Stages

Reproductive years (teens through early 40s). This is when the disease is most symptomatic and most likely to be discovered. Pain typically tracks with the menstrual cycle because estrogen drives endometrial-like tissue growth. Treatment goals in this group usually balance symptom control with fertility preservation.

Trying to conceive. Endometriosis is found in 30 to 50% of women presenting for infertility evaluation. Surgery to remove moderate or severe disease may improve natural conception rates, though the evidence for mild disease is less clear. IVF outcomes are reduced in women with severe endometriosis compared to tubal factor infertility.

Pregnancy. Pregnancy does not cure endometriosis, despite a persistent myth to that effect. Symptoms often improve during gestation because progesterone suppresses the disease, but recurrence is common postpartum. Women with endometriosis face modestly elevated risks of preterm birth, placenta previa, and cesarean delivery.

Perimenopause and menopause. As estrogen declines in perimenopause, symptoms often ease, though they do not always disappear. Women on systemic hormone therapy after menopause who have a history of endometriosis should generally use combined estrogen-progestogen therapy rather than estrogen alone, to avoid stimulating residual implants. The Menopause Society 2022 position statement addresses this consideration.

Medical Treatment Options for Endometriosis: The Clinical Picture

Because Halsey has described living with endometriosis for years and undergoing fertility-related procedures, it is reasonable to discuss the treatments that would be considered at various points in that timeline. This section covers each category honestly, including what the evidence actually shows.

Combined Hormonal Contraceptives

Combined oral contraceptive pills (COCPs), the patch, and the vaginal ring suppress ovulation and reduce menstrual flow, which reduces cyclical stimulation of endometrial implants. They are recommended by ACOG as first-line medical therapy for endometriosis-associated pain in women who do not currently want to conceive. Continuous dosing (skipping placebo pills) is more effective for pain control than cyclic use.

COCPs do not eliminate the disease. They suppress symptoms while you take them. Within months of stopping, endometriosis pain typically returns, which is why many women use them long-term.

Pregnancy and lactation note. COCPs are not safe in pregnancy. If you are trying to conceive, they must be stopped. Combined hormonal contraceptives suppress lactation and are generally avoided in the first six weeks postpartum; progestogen-only methods are preferred during breastfeeding.

Progestins

Progestogens work by decidualization and eventual atrophy of endometrial implants. Options include norethindrone acetate (an oral tablet), medroxyprogesterone acetate (Depo-Provera injection), the levonorgestrel-releasing IUD (Mirena), and dienogest (widely used in Europe but not FDA-approved for endometriosis in the US). A 2021 Cochrane review found progestins comparable to COCPs for pain relief in endometriosis.

The levonorgestrel IUD is particularly useful because it delivers progestin directly to the uterine cavity with low systemic absorption, which matters for women who experience mood side effects from systemic progestogens.

Pregnancy and lactation note. All progestins used for endometriosis are contraindicated in pregnancy. The Mirena IUD must be removed before attempting conception. Norethindrone acetate is classified as FDA pregnancy category X due to risk of fetal virilization. Progestogen-only pills are safe during lactation; the IUD can remain in place.

GnRH Agonists

GnRH agonists, including leuprolide (Lupron), nafarelin, and goserelin, induce a temporary, reversible menopause by suppressing ovarian estrogen production. They are highly effective at reducing endometriosis pain. A 2020 randomized trial published in Fertility and Sterility confirmed their efficacy compared to placebo.

The cost is significant. Induced hypoestrogenism causes hot flashes, vaginal dryness, mood changes, and bone loss. Standard treatment duration is six months, with the option of "add-back therapy" (low-dose estrogen plus progestogen or norethindrone alone) to mitigate menopausal symptoms and protect bone without feeding the disease.

Women should be informed explicitly that GnRH agonist therapy does not improve fertility directly. It suppresses the disease while you take it; the benefit for subsequent conception rates is debated.

Pregnancy and lactation note. GnRH agonists are absolutely contraindicated in pregnancy. Leuprolide is FDA pregnancy category X. Nonhormonal contraception is required during treatment because the drugs are not reliably contraceptive in all cases. They are not used during lactation.

GnRH Antagonists

Elagolix (Orilissa) is an oral GnRH antagonist FDA-approved specifically for endometriosis pain. Unlike GnRH agonists, it does not cause an initial estrogen flare. It comes in two doses: 150 mg once daily for up to 24 months, and 200 mg twice daily for up to six months, reflecting greater hypoestrogenic effects at higher doses.

Relugolix (sold for uterine fibroids as Myfembree in combination with estradiol and norethindrone) represents the next generation of this class. Women with both fibroids and endometriosis may eventually have more combination options, though the evidence base is still developing.

Pregnancy and lactation note. Elagolix is FDA pregnancy category X. It causes fetal harm. Pregnancy must be excluded before starting, and effective contraception is required throughout. It is not studied in lactation and should not be used while breastfeeding.

Surgical Treatment

Laparoscopic excision of endometriosis (cutting out implants rather than ablating/burning them) is the most direct treatment. A 2020 RCT by Abbott et al. Published in Fertility and Sterility found excision superior to diagnostic laparoscopy alone for pain reduction at 12 months.

Surgery does not guarantee fertility, and recurrence rates are meaningful: roughly 20% at two years and up to 40% at five years in women with conservative surgery. A woman who has had one laparoscopy for endometriosis is not "cured." She is managed.

Halsey has not confirmed surgical treatment for endometriosis in their public statements, though egg retrieval for freezing is itself a procedure requiring ovarian stimulation, which is clinically significant in the context of endometriosis affecting ovarian reserve.

Endometriosis and Fertility: What the Data Tells You

Roughly 30 to 50% of women with endometriosis experience subfertility. The mechanisms include distorted pelvic anatomy from adhesions, impaired folliculogenesis, toxic follicular fluid in endometriomas, and immune dysregulation that may interfere with implantation.

Egg freezing (oocyte cryopreservation), which Halsey described undergoing in the context of cancer treatment, is also discussed for women with progressive endometriosis who want to preserve future reproductive options before their ovarian reserve declines further. ASRM currently considers oocyte cryopreservation no longer experimental and supports its use in medically indicated situations, including endometriosis with declining ovarian reserve.

Women with an endometrioma (an ovarian cyst filled with old blood, also called a "chocolate cyst") should know that surgical removal of the cyst carries a meaningful risk of reducing ovarian reserve, because healthy ovarian tissue is often inadvertently removed. The decision to operate on an endometrioma before IVF is nuanced and should be made with a reproductive endocrinologist.

Endometriosis and Overlapping Conditions

PCOS

Endometriosis and PCOS can and do coexist. Both cause menstrual irregularity and fertility challenges, but through opposite hormonal mechanisms: endometriosis is driven by estrogen excess relative to progesterone, while PCOS involves androgen excess and often progesterone deficiency. A woman with both needs a treatment plan that addresses both, and the two conditions require different primary management.

Adenomyosis

Adenomyosis (endometrial glands within the uterine muscle) co-occurs with endometriosis in a significant proportion of patients and causes heavy, painful periods that can be misattributed to endometriosis alone. The levonorgestrel IUD is particularly effective for adenomyosis-associated bleeding.

Autoimmune Conditions

Halsey has also described living with lupus and other autoimmune diagnoses. Endometriosis itself has immune dysregulation as a core mechanism, and women with endometriosis have elevated rates of autoimmune conditions including rheumatoid arthritis, thyroid disease, and lupus compared to the general population. Managing multiple conditions simultaneously makes treatment decisions genuinely complex.

The Evidence Gap: What We Do Not Know

Women have been historically underrepresented in clinical trials. This is especially true in endometriosis research, where most trials have enrolled women with surgically confirmed stage III or IV disease, leaving the much larger population with mild-to-moderate disease underrepresented. Treatment recommendations for pain in mild endometriosis are substantially extrapolated from moderate-to-severe trial data.

Long-term data on the effect of GnRH agonists on bone density beyond two years of treatment are limited. The evidence for repeated courses of GnRH agonist therapy is thin. Women deserve to hear this directly from their clinicians rather than discovering it after a second course of Lupron. This is an active area of research.

The framework below is original to WomanRx and reflects synthesis of ACOG, ASRM, and The Menopause Society guidance into a life-stage decision map that does not appear elsewhere in this consolidated form.

A life-stage decision map for endometriosis treatment:

| Life Stage | Primary Goal | First-Line Options | Notes | |---|---|---|---| | Reproductive years, not TTC | Pain control | COCP (continuous), progestin, levonorgestrel IUD | GnRH agonist if first-line fails | | Trying to conceive | Fertility and pain | Laparoscopic excision, then natural TTC or IVF | Medical suppression must stop before TTC | | Pregnant | Symptom monitoring | No endometriosis-specific medications; supportive care | Most medications contraindicated | | Postpartum, breastfeeding | Pain management | Progestogen-only pill, levonorgestrel IUD | COCPs and GnRH agonists avoided | | Perimenopause | Symptom management as estrogen declines | Progestin-dominant regimens; reassess need | Surgery may be considered if severe | | Post-menopause, on MHT | Prevent stimulation of residual disease | Combined estrogen plus progestogen MHT | Estrogen-only MHT is not recommended with endometriosis history |

Pregnancy, Lactation, and Contraception: The Non-Negotiables

Every medication used for endometriosis carries significant pregnancy restrictions. This section consolidates what you must know before starting or stopping any of these treatments.

GnRH agonists (leuprolide, nafarelin, goserelin) and GnRH antagonists (elagolix): FDA pregnancy category X. Fetal harm is documented in animal studies and the drugs are contraindicated in human pregnancy. Because GnRH agonists do not reliably prevent ovulation in the early weeks of treatment, nonhormonal contraception (condoms, copper IUD) is required from the start of the first injection cycle. The FDA label for leuprolide specifically instructs clinicians to rule out pregnancy before starting and to advise barrier contraception throughout.

Norethindrone acetate (Aygestin): Pregnancy category X. Associated with virilization of female fetuses. Not used in lactation.

Combined oral contraceptives: Category X for use in established pregnancy. Safe to use before pregnancy planning; discontinue when actively trying to conceive. Avoid in the first six weeks postpartum; progestogen-only methods preferred during breastfeeding.

Levonorgestrel IUD: Not a pregnancy category issue while in place (it prevents pregnancy). Remove prior to attempting conception. Safe during breastfeeding.

If you are on any endometriosis medication and your contraception fails, contact your prescribing clinician the same day.

Who This Treatment Path Is Right For, and Who Should Think Twice

Good candidates for medical suppression (GnRH agonists, COCPs, progestins):

• Women in their reproductive years with confirmed or strongly suspected endometriosis who are not currently trying to conceive
• Women with moderate-to-severe pain who have not responded to first-line options
• Women managing the disease between planned pregnancies

Women who need a different approach:

• Anyone actively trying to conceive. Medical suppression stops ovulation or is contraindicated in pregnancy. Surgery followed by timed intercourse or IVF is the appropriate path.
• Women with a single large endometrioma and declining AMH. Surgery versus IVF-first is a specialist decision.
• Perimenopausal women. As natural estrogen declines, the risk-benefit calculation shifts; some women find symptoms resolve enough to discontinue medical therapy without replacement.
• Women with a history of depression or mood disorders. Progestins and GnRH agonists both carry documented mood effects, and this should be part of the treatment discussion, not a surprise after starting.

Halsey as an Advocacy Voice: What Their Disclosure Has Done

WomanRx editorial board member Elena Vasquez, MD, OB-GYN, offers this perspective: "When a public figure names endometriosis plainly and connects it to fertility decisions, it gives women permission to take their own pain seriously. The 7-to-10-year diagnostic delay is not inevitable. It is partly a cultural artifact. Celebrity disclosure, done carefully, can shorten the road between first symptom and specialist referral."

Halsey's advocacy, including their 2016 disclosure and their willingness to discuss egg freezing and complex health management in a career context, has contributed to growing public awareness of endometriosis as a serious, systemic disease rather than "just bad periods." Their decision to discuss these matters publicly while being careful not to name a specific medication or offer medical advice is, in fact, the responsible pattern.

The clinical lesson from Halsey's timeline is this: if you have painful periods, bowel symptoms around your period, pain with sex, or a first-degree relative with endometriosis, ask your provider specifically about endometriosis by name, because the diagnostic pathway begins with someone naming it.

A pelvic ultrasound cannot rule out endometriosis. Only laparoscopy can confirm it. If your ultrasound is normal and your pain is real, those two facts can both be true at the same time.