The following hormone treatments are available to those with endometriosis:
Combined oral contraceptive pill (‘the Pill’)
The Pill contains a mixture of oestrogen and progesterone. The Pill works by suppressing ovulation and affects the production of female hormones in the ovary. The hormones in the Pill cause the uterus lining to become thinner, causing periods to become shorter and lighter, thus reducing endometriosis symptoms. The Pill is used to treat women with mild symptoms. As the Pill has side effects, women normally have to experiment with different brands until they find one that suits them.
The Mirena coil is a small plastic T-shaped intrauterine device. It contains a progestogen (progesterone-like substance) that is released into the womb over a period of 5 years. The Mirena coil does not always stop ovulation.
Progesterones are thought to relieve the symptoms of endometriosis by suppressing the growth of endometriosis deposits and may also reduce endometriosis-induced inflammation. During treatment a woman will stop ovulating and menstruating.
Drugs containing progesterones that are typically used to treat endometriosis are:
- Medroxyprogesterone (Provera)
- Norethisterone (Primolut)
- Dydrogesterone (Duphaston)
- Depo-Provera
Depo-Provera differs from the other progestogens. Rather than be administered in pill form, Depo-Provera is injected. It has to completely leave the woman’s body before she will start ovulating and menstruating again. The length of time this takes will depend on the dose used and how rapidly their body absorbs the drug. Patients can experience long delays in the return of their periods and a few women may not menstruate for more than a year after their last injection. It is recommended that you do not use Depo-Provera if you wish to try for a family soon after treatment.
GnRH analogues are modified versions of a naturally occurring hormone known as gonadotropin releasing hormone (GnRH), which helps to control the menstrual cycle. When used continuously for periods of longer than 2 weeks, these drugs stop the production of oestrogen, essentially placing the body in a temporary menopausal state. This ‘starves’ the endometriosis of oestrogen, causing the deposits to become inactive and reduce. It is often recommended that a woman takes ‘add-back’ therapy or HRT to reduce or even prevent the side effects of these drugs.
The most commonly used GnRH analogues used to treat endometriosis are:
- Leuprorelin (Prostap)
- Goserelin (Zoladex)
- Nafarelin (Synarel)
- Buserelin (Suprecur)
- Triptorelin (Decapeptyl)
Testosterone is a male hormone (androgen). These drugs are synthetic (scientifically created) androgens. As these drugs decrease the production of oestrogen and progesterone, this in turn decreases the stimulation of the endometriosis stopping it from growing further inside the body.
The two mostly commonly used drugs used to treat endometriosis are Danazol and Gestrinone.
Danazol contains a form of testosterone. It creates a menopause-like state. Most of the women who take Danazol stop having a menstrual cycle and many experience other side effects. Due to its many side effects, Danazol is now used only as a ‘second line’ treatment for endometriosis when other drug treatments have been tried without success.
Gestrinone (Dimetriose) also contains a form of testosterone and its side effects are similar to Danazol – although reportedly not as severe.
We are grateful to www.endometriosis.org for their help with this information.
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