Drug Treatments for Endometriosis
It All Comes with a Price
While treating endometriosis with hormone drugs does result in some relief or improvement of symptoms, there are many things to consider before embarking upon this type of treatment. Chances of conception, should a woman desire pregnancy, are not improved and symptomatic relief is often temporary. Medical treatment does not remove endometriosis, rather it suppresses it and is good for short-term management of symptoms.
The Philosophy of Drug Therapy for Endometriosis
The idea behind drug therapy is to stop the normal hormonal cycle of the ovaries by reducing estrogen levels, thereby shrinking the endometrial tissue. By affecting the chemical and hormonal levels in the body, the natural processes are affected - and so are the endometrial growths. Both pseudo-pregnancy and pseudo-menopause can be induced with drugs and both have been shown to cause endometriosis to regress. By being well informed and advised about the treatments and their side-effects, a woman can make an educated decision about drug treatment for endometriosis.
Birth Control Pills
Birth control pills are one of the most common hormone treatments for endometriosis and, when compared to GnRH agonists, they were found to provide an equal improvement insofar as pelvic pain, painful periods and painful sex are concerned. Using the BCP for treatment means the pill is used continuously; tricking the body into thinking it is pregnant. Side effects include weight gain, acne and hair growth on the face.
Gestrinone and Danazol - The Good and Bad News
Gestrinone influences estrogen production in the ovaries and works much like Danazol, a male testosterone hormone. This treatment is taken twice a week and has side effects which include weight gain, acne, depression, mood swings, hot flushes and a loss of libido. Danazol, as mentioned, is a male hormone which reduces the amount of estrogen produced to levels comparative to menopause - mimicking pseudo-menopause. Danazol has a variety of side effects, including: weight gain, increased body and facial hair growth, acne, smaller breasts, increased muscle mass, deepening of the voice and mood swings along with the possibilities of gastrointestinal upsets, depression and liver disease.
The Drug of Choice
The ‘wonder drug' for endometriosis has surfaced in the form of GnRH agonists which act in the same way as the body's gonadotrophin releasing hormone. This hormone is produced by the pituitary gland and it stimulates the ovaries to both produce estrogen and develop eggs. GnRH agonists, when administered, flood the system and interfere with the body's balance causing blockage of egg development, estrogen production and the menstrual cycle. The net result is menopause for the time you are taking the treatment. Without the stimulation of estrogen, endometriosis shrinks and becomes inactive. The side effects of using GnRH agonist drugs are equivalent to menopause, including hot flushes, vaginal dryness, headaches, depression, bone loss, night sweats and loss of libido. To counteract these side effects, add-back therapy can be employed which is, effectively, hormone replacement therapy.
Progesterone - Most Frequent Choice
The most commonly used medical treatment for endometriosis is progesterone, which opposes the estrogen effects on endometrial growths, causing them to shrink. Progesterone also prevents ovulation, thus lowering estrogen levels as well. The side effects are irregular bleeding, weight gain, mood changes, bloating, fatigue, depression and nausea.
Most drug therapies are effective in varying degrees; however, most have very unpleasant side-effects with no proven benefits relative to fertility or preventing recurrence of the disease.