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Thousand of women are diagnosed each year with Endometriosis. There are many options for treatment of this disease, many of which are intrusive such as surgery. If however, your physician has ruled out surgery for any number of reasons, there are hormonal treatment options that are being used.
The belief currently is that there is no real cure for endometriosis. Treatment is aimed toward controlling the pain and preventing the condition from worsening over time. Most birth control options are also used as hormonal medicines, so you may already be informed of this type of treatment for endometriosis. However, it is important that you understand the different options that are available and the risks associated with each treatment. If you have certain medical conditions, hormonal therapy may not be the best approach to dealing with the symptoms of this disease. A history of blood clots or heart disease would likely prevent you from being a candidate for hormonal therapy. It is important that you discuss these options with your gynecologist to gain any information that you need to make an informed decision. Contraceptives or birth control pills combine estrogen and progestin and are taken in a cycle. There are twenty-eight contraceptive pills in each monthly package. Typically seven of these are simply reminders or placebos, while the remaining twenty-one pills contain the hormones used for treatment. Oral contraceptives work by temporarily shutting down ovarian production. Oral contraceptives have been used to treat painful periods and the pain of endometriosis, but again those with a history of blood clots and other medical conditions are typically not candidates for this treatment. The patch is hormone therapy that you wear. It resembles a square band-aid and is worn on your skin. The medicine in the patch is the same as that in oral contraceptives. The advantage of using this form of treatment is that you do not need to remember to take a pill each day. You simply change the patch once each week for three weeks and then you go off it for one week. The patch has been prescribed for many women with irregular period and painful menstrual cramps, as well as those who have been diagnosed with endometriosis. The disadvantage of the patch is that it contains the same hormones as oral contraceptives so those with a history of blood clots, those who smoke or women over the age of 35 are typically not candidates for this treatment. Vaginal rings are small, flexible rings that fit inside your vagina. Once the ring has been placed, it releases a combination of estrogen and progestin, the same hormones in contraceptive pills and patches. The vaginal ring can be used to treat the pain of endometriosis because it controls your menstrual cycle. The ring is typically removed after three weeks and left out for one week, which is typically the week in which you would have your period. Many women prefer the vaginal ring to oral contraceptives and the patch because it does not require any maintenance during the three-week period in which it is in place. There are no pills to take and no patch to replace weekly. It is placed inside the vagina where it is not visible, which is another advantage that many women prefer. The combined estrogen and progestin therapy may decrease with the vaginal ring and in many cases, this combination can completely stop the pain of endometriosis. Another advantage for some women is a much lighter and shorter menstrual period. The disadvantages or possible side effects of an estrogen/progestin combination include spotting or irregular bleeding, mood swings, nausea, bloating and weight gain. Some women have also reported spotting and many women have reported that this combination of hormones did not stop their endometriosis pain. Progesterone based hormonal therapy is also an option for women with endometriosis. Progesterone therapies can be effective for those who cannot take estrogen. The benefits of progesterone-only treatments are that this therapy option can be effective in treating the pain and other discomforts of the disease. Disadvantages or possible side effects include a higher risk of osteoporosis if the treatment is prolonged, breast tenderness, weight gain, mood swings and hair thinning.
GnRh agonists and Hormonal add-back therapy is typically used when all other hormonal medicines have proven to be ineffective. Since GnRH Agonists can only be used for six months at a time, the Add-Back therapy is a way of keeping women on the hormone for a longer period of time by adding a small amount of estrogen and progesterone. The benefits of using this combination is that the Add-Back therapy helps to ward off osteoporosis and to protect against hot flashes and other unwanted side effects. Bone density tests or DEXA scans can be used to ensure that bones are healthy, giving the option of staying on this therapy for a longer period of time.
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