Endometriosis - Medications

Highlights	Complications	Conservative Surgery
Introduction	Diagnosis	Hysterectomy
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Risk Factors	Medications

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Medications

The basic approach in hormonal treatments for endometriosis is to block production of female hormones (estrogen and progesterone) or to prevent ovulation with other hormonal effects. Hormonal agents are used for pain relief only. None improve fertility rates and in some cases may delay conception. Specific hormonal agents may have different effects for women with endometriosis.

Inducing Pseudopregnancy: Agents that. Oral contraceptives that contain estrogen and progestins mimic a pregnant state and block ovulation. (Progestins are natural or synthetic forms of progesterone). Progestins may also be used alone, since they have specific effects that can cause the endometrial tissue itself to atrophy.
Inducing Pseudomenopause: Gonadotropin-releasing hormone (GnRH) agonists or gestrinone, an anti-progesterone that mimic menopause. They reduce estrogen and progesterone to their lowest level.
Inducing On-going Blockage of Ovulation. Danazol, a derivative of male hormones, is a powerful ovulation blocker.

At this time, studies report that between 80% and 85% of women achieve pain relief after taking these agents. To date, comparison studies have found few differences in effectiveness among the major hormonal treatments. Differences occur mostly in their side effects. It should be noted that research on hormonal treatments for endometriosis is very scanty, and even physicians may not have the best data needed to make optimal decisions for their patients. Women should discuss the effects of particular medications with their physicians to determine the best choice.

Oral Contraceptives

Oral contraceptives (OCs), commonly known collectively as "the Pill," contain combinations of an estrogen and a progestin (either a natural progesterone or the synthetic form called progestogen). They are most often used for treating endometriosis and are as effective for most women in treating pain from endometriosis as the more potent gonadotropin releasing hormone agonists. OCs may reduce the risk of ovarian cancer by 30% to 50% and of endometrial cancer by 50%, which is a potentially important benefit in women with endometriosis. (Patch contraceptives are available, but they may increase the risk for menstrual cramping.)

Click the icon to see an illustrated series detailing the birth control pill.

When used throughout a menstrual cycle, they suppress the actions of other reproductive hormones (luteinizing hormone, or LH, and follicle stimulating hormone, or FSH) and prevents ovulation. There are many brands available. The estrogen compound used in most oral contraceptives is estradiol. Many different progestins are used, and there are many brands. None to date have proven to be superior over others. Women should discuss the best options for their individual situations with their physician.