Drug Therapy For Endometriosis

There is a lot to know about this disorder. Since it can’t all be covered in this section it would be advisable to speak to a healthcare provider for details.

Endometriosis is a disease that results in the abnormal growth of uterine cells outside the uterus resulting in scar tissue and adhesions. Diagnoses range from mild to severe, and each diagnosis may or may not contribute to infertility. The disorder can definitely cause a mechanical interference in the reproductive system, but this is not always the case. Laparoscopy can determine the severity of the disorder and surgery can sometimes minimize it. For some forms, drug therapy is prescribed. This treatment model for mild endometriosis may prevent further development of the disease.

How It Works

If the endometriosis is causing you pain, your physician may recommend managing it with over-the-counter pain relievers. Depending on your case and goals of care, your physician may prescribe one of the following hormone therapies (most of which will also prevent pregnancy) to help manage the condition:

  • Contraceptives (i.e. birth control pills, patches or vaginal rings) help regulate the hormones responsible for building the endometrial lining each month, and have been shown to have potential beneficial effects on endometriosis.
  • GnRH analogues work by inhibiting output of gonadotropins (LH and FSH) from the pituitary and decreasing estrogen levels. This achieves a menopause-like state, which results in an atrophy of the endometrial tissue in the uterus and fallopian tubes. Typically, menstruation will stop while on this type of medication.
  • Synthetic progesterones (called progestins) act by a number of mechanisms, including inhibiting gonadotropin secretion, which causes the atrophy of the endometrial implants.

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Side Effects

There are risks and side effects associated with drug therapy for endometriosis, depending on the type of treatment recommended for your case by your physician.

The most common side effects of hormonal contraceptives are nausea and vomiting, abdominal cramps/bloating, breast discomfort, headache, breakthrough bleeding or spotting, painful menstruation, weight gain and mood changes. Additionally, there may be discomfort with the use of vaginal rings, or skin irritation with the use of patches. A small number of women experience serious side effects of hormonal contraceptives including serious blood clots (e.g. in the lungs, heart, eye, brain, or legs), breast cancer, gallbladder disease, or liver tumours.

If treated with GnRH analogues, common side effects may include hot flushes, vaginal dryness, heavy periods, gastrointestinal disturbances, decreased libido, muscle or joint pain, breast pain, vaginitis, mood changes, nervousness, or headache. A skin reaction (e.g. itching/burning, redness, swelling or bruising) may occur at the injection site, though these are typically mild and resolve within days. Nasal irritation or dryness may occur with nasal preparations. The most serious side effects, though uncommon, may include headache, nausea/vomiting, swelling or numbness of limbs, convulsions, bone pain, severe pain in the chest/abdomen, or vision changes.

The most common side effect of synthetic progesterone treatment is changes in menstrual patterns (e.g. irregular bleeding, spotting, or rarely, continuous bleeding). Other common side effects include weight gain, headache, and abdominal discomfort. Serious side effects may include abdominal pain, nausea/vomiting, persistent sad mood, swelling of the limbs, skin reaction at the injection site, and bone fractures due to loss of bone mineral density.

There is a lot to know about endometriosis. For more information, couples should have a healthcare provider suggest further resources. The following websites offer additional details on this condition:

http://www.endometriosisassn.org
http://www.endocenter.org


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