This consists of different types of hormone treatments and is aimed at relieving symptoms in particular those of pain. Often these drugs may:
- Bring about an improvement in the pain symptoms
- Shrink or slow down the progression of the condition
- Delay the recurrence of the disease
- Hormonal treatments may have side effects
Commonly used drugs include:
- Medroxyprogesterone (Provera)
- GnRH analogues
- Triptorelin (Gonapeptyl)
- Goserelin (Zoladex)
- Leuprorelin (Prostap)
- Combined oral contraceptive pill
- Mirena intra-uterine system (IUS)
- Depo-provera injection
It is important to avoid a pregnancy whilst receiving hormonal treatments. The Mirena system, Depo-provera and the oral contraceptive pill provide effective contraception. However, the other hormone treatments do not provide effective contraception cover and therefore you are advised to use alternative methods of contraception such as the barrier method whilst receiving these treatments.
These hormones (GnRHa) temporarily switch off the ovaries and stop production of oestrogen production. This results in a temporary but reversible menopause. This tends to cause shrinkage of endometriosis, as the condition is oestrogen dependant. Lack of periods and shrinkage of endometriosis with these drugs tend to give an improvement of the symptoms. However, the condition tends to come back after the treatment is discontinued.
We use GnRHa prior to surgery to shrink and reduce vascularity of endometriosis to facilitate surgery. They are occasionally used after or instead of surgery in selected patients.
These drugs are usually given for three to six months and most women feel better during treatment. If you are prescribed GNRHa prior to surgery it is important to stop any hormonal preparation you are taking except where specifically instructed otherwise. Sometimes drugs may be used for longer, but in such situations additional hormone replacement therapy is given to prevent osteoporosis and menopausal symptoms.
Gonapeptyl, Zoladex and Prostap are given as an injection once a month. It is important that you are not pregnant when beginning treatment. These drugs do not provide effective contraception and therefore some form of barrier method must be used during treatment.
Some women experience no side effects. Others may experience some the following symptoms:
- Hot flushes
- Decreased sex drive (libido)
- Mood changes
- Breast changes
These side effects generally reduce within a few weeks to months of completing treatment. With longer use osteoporosis may also occur.