Endometriosis : Part 3

by National Institute of Health

(Page 3 of 4)

What are the hormone treatments for endometriosis pain?

Because hormones cause endometriosis to go through a cycle similar to the menstrual cycle, hormones can also be effective in treating the symptoms of endometriosis. In fact, if a woman's symptoms do not respond to hormone therapy, health care providers may go over their diagnosis of endometriosis again, to make sure she really has the condition.

Health care providers may suggest one of the following hormone treatments:

Oral contraceptives or birth control pills - regulate the growth of the tissue that lines the uterus and often decrease the amount of menstrual flow. In general, the therapy contains two hormones, estrogen and progestin.

It often works as long as you take the pills. Once you stop the treatment, your ability to get pregnant returns, and your symptoms of endometriosis may also return. Many women continue the treatment indefinitely. Some women take birth control pills continuously, without using the sugar pills that signal the body to go through menstruation. When birth control pills are taken in this way, the menstrual period may stop altogether, which can reduce pain or get rid of it entirely.

Some birth control pills contain only progestin, a progesterone-like hormone. Women who can't take estrogen use these pills to reduce menstrual flow. Some women may not have pain for several years after stopping treatment. You may have some mild side effects from these hormones, such as weight gain, bleeding between periods, and bloating.

Progesterone and progestin - improve symptoms by reducing a woman's period or stopping it completely.

As a pill taken daily, these hormones will reduce menstrual flow without causing the lining of the uterus to grow. As soon as you stop taking the pill form, you can get pregnant and your symptoms may return. As an injection taken every three months, these hormones will usually stop menstrual flow. It may take a few months for your period to return after you stop taking the injections. When your period returns, so does your ability to get pregnant. You may gain weight or feel depressed while taking these hormones.

Danocrine - stops the release of hormones that are involved in the menstrual cycle.

You will probably get your period only now and then while taking this drug; or, you may not get it at all. You should take steps to prevent pregnancy while you are on this medication because danocrine can harm a baby growing in the uterus. Because you should avoid taking other hormones, like birth control pills, while on danocrine, health care providers recommend that you use condoms, a diaphragm, or other "barrier" methods to prevent pregnancy. Common side effects include oily skin, pimples or acne, weight gain, muscle cramps, tiredness, smaller breasts, and breast tenderness. You may also have headaches, dizziness, weakness, hot flashes, or a deepening of your voice while on this treatment.

Gonadatropin-Releasing Hormone (GnRH) Agonists - block the production of certain hormones to prevent menstruation, which slows or stops the growth of endometriosis, sending the body into a "menopausal" state.

GnRH agonist is used daily in a nose spray, or as an injection given once a month or every three months. Most health care providers recommend that you stay on the GnRH agonist for about six months. After that time, your body will come out of the menopausal state. You'll start having your period again and could get pregnant. After women stop taking GnRH agonists for six months, about 50 percent have some return of their endometriosis symptoms. These medications also have side effects, including hot flashes, tiredness, problems sleeping, headaches, depression, bone loss, and vaginal dryness.

Current research is exploring the use of other hormones in treating endometriosis and pain related to endometriosis. Some of these include GnRH antagonists, selective progesterone receptor modifiers, and selective estrogen receptor modulators, also known as SERMs. For more information about these hormones, talk to your health care provider.

Some women also have less pain from endometriosis after pregnancy, but the reason for this is unclear. Researchers are trying to determine whether it is because the hormones released by the body during pregnancy also lessen the growth of endometriosis, or if pregnancy causes changes in the uterus or endometrium that lessen the growth of endometriosis.

What are the surgical treatments for endometriosis pain?

If you have severe pain from endometriosis, your health care provider may suggest surgery. At surgery, your health care provider can locate any endometriosis and see the size and degree of growth; he or she may also remove the endometriosis at that time.

You and your health care provider should talk about possible options for removing endometriosis before your surgery. Then, based on the findings and treatment at surgery, you and your health care provider can discuss medical treatment options for after surgery.

Health care providers may suggest one of the following surgical treatments:

Laparoscopy - is a way to diagnose and treat endometriosis without making large cuts in the abdomen.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.