Endometriosis is a complex condition that may require treatment with a number of different medications before an effective method is found. In fact, drugs may not be enough. In some cases, particularly when endometriosis has spread significantly or is causing a woman difficulty in getting pregnant, surgery may be required, either preceded or followed by drug treatment.
Prevention Or Cure?
It's important to be aware that none of the medical treatments described below constitute a cure for endometriosis. Most endometriosis patients will experience a recurrence of the condition after discontinuing these treatments. Furthermore, these medications are hormone-based and could potentially be dangerous to a fetus during pregnancy. However, even though these drugs put the body into a state of artificial menopause or pregnancy, they are not reliable as a form of contraception. You must use a barrier method of contraception (for example, condoms) while taking these medicines.
Hormonal drug treatment is aimed at relieving uncomfortable endometriosis symptoms. If the treatment is successful and excess endometriosis growth is reduced, it may be possible for a woman to stop the treatment and get pregnant afterwards.
All these drugs reduce estrogen production and stop your periods. Estrogen is the hormone that encourages endometriosis tissue to grow, swell and eventually (during menstruation) bleed. The shedding tissue located outside the uterus, however, cannot leave the body through the vagina, so it gets trapped - causing pain and discomfort for the sufferer.
These synthetic hormone drugs mimic the effects of a naturally produced reproductive hormone called progesterone. The drugs are usually injected. Progestogens act on the ovaries - stopping them from releasing eggs (basically, preventing ovulation from taking place). This lowers the body's estrogen levels and shrinks endometrial tissue.
Side effects of these drugs include: bloating, emotional highs and lows, irregular bleeding, weight gain and decreased bone density.
Antiprogestogens and GnRHs
Both these types of drugs put the body into a temporary menopausal state and give rise to menopause-type symptoms. They are sometimes offered in conjunction with hormone replacement therapy to prevent these menopausal effects.
Antiprogestogens are testosterone derivatives (i.e. synthetic male hormones). They block the body's production of the ovarian-stimulating hormones estrogen and progesterone. Without these female hormones, which are essential for reproduction, the body goes into menopause. The lack of estrogen reduces the growth of endometriosis tissue and provides symptom relief. Unfortunately, the side effects of these drugs include hot flashes, vaginal dryness and the development of male features (facial hair and deepening of the voice).
GnRHs - or gonadotropin releasing hormones - are synthetic hormones that stop estrogen production after two weeks of use. They are usually administered either as a nasal spray, an injection or an implant. Once estrogen levels go down, the irritation caused by endometriosis tissue diminishes.
The side effects of GnRHs are very similar to those of antiprogestogens. This is why they and antiprogestogen drugs are often used only as a temporary measure in order to make a woman more comfortable or to boost her fertility when treatment is stopped. In the case of mild to moderate endometriosis, taking the combined contraceptive pill is a less severe hormonal treatment for the control and management of this condition.