Endometriosis - Lifestyle Changes

Medications

The basic approach in hormonal treatments for endometriosis is to block production of female hormones (estrogen and progesterone) or to prevent ovulation. Hormonal drugs are used for pain relief only. They do not improve fertility rates and in some cases may delay conception. Specific hormonal drugs may have different effects for women with endometriosis.

• Inducing Pseudopregnancy. Oral contraceptives that contain estrogen and a progestin mimic a pregnant state and block ovulation. (Progestins are synthetic forms of progesterone). Progestin may also be used alone, since it has specific effects that can cause the endometrial tissue to atrophy (shrink).
• Inducing Pseudomenopause. Gonadotropin-releasing hormone (GnRH) agonists reduce estrogen and progesterone to their lowest levels.
• Inducing On-going Blockage of Ovulation. Danazol, a derivative of male hormones, is a powerful ovulation blocker but has very unpleasant side effects.It is rarely used now.

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Most women achieve pain relief after taking these drugs. To date, comparison studies have found few differences in effectiveness among the major hormonal treatments. Differences occur mostly in their side effects. Women should discuss the effects of particular medications with their doctors to determine the best choice.

Oral Contraceptives

Oral contraceptives (OCs), commonly called birth control pills or "the Pill," contain combinations of an estrogen and a progestin. Combined oral contraceptives are a first-line treatment for endometriosis pain. They are generally used along with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

Click the icon to see an illustrated series detailing the birth control pill.

When used throughout a menstrual cycle, OCs suppress the actions of other reproductive hormones (luteinizing hormone [LH] and follicle stimulating hormone [FSH]) and prevent ovulation. There are many brands available. The estrogen compound used in most oral contraceptives is estradiol. Many different progestins are used, and there are many brands. None to date have proven to be better than others. Women should discuss the best options for their individual situations with their doctor.