Ongoing medical care from your primary care provider and a pulmonologist (preferably one who specializes in LAM) is essential. Because the disease primarily affects women, doctors believe that the hormone estrogen may play a role in causing LAM. If you are thinking about getting pregnant or starting oral contraceptives (birth control pills), be sure to talk with your doctor first. Many doctors believe that pregnancy may accelerate the progression of LAM. Adoption, gestational surrogacy and traditional surrogacy are some of the options that you may consider as viable alternatives. Women with LAM and TSC are advised to consult with their physician specialist(s).