Improvements in endometriosis symptoms, such as spotting, can typically be seen after 1 to 3 months of treatment with a medication like Visanne. It is important to take the medication consistently at the same time every day for optimal results. Some side effects, such as spotting or abdominal pain, may initially increase but should improve over time as your body adjusts to the hormonal changes. If these symptoms become too bothersome or abnormal, it is recommended to discuss with your doctor possible alternatives or the risks and benefits of continuing the same treatment.