Medical Treatments for Endometriosis

Our doctors may prescribe oral contraceptives, or birth control pills, to women who aren’t planning to become pregnant soon. They may recommend that these contraceptives be taken continuously—meaning you skip the placebo pills and immediately begin another package of birth control pills. When these contraceptives are taken without a break for menstruation, the lining of the uterus thins and stabilizes, and periods stop. Often, this lessens or eliminates the pain associated with endometriosis and decreases the chances that implants regrow. In some women, spotting or breakthrough bleeding occurs during the first few months of taking birth control pills but then typically subsides.

An injectable method of birth control, medroxyprogesterone, or Depo-Provera^®, is a synthetic form of the hormone progesterone, in a class of drugs called progestins. Progesterone helps prepare the lining of the uterus to receive a fertilized egg. Progestins cause the uterine lining to thin and endometrial implants to shrink, thereby reducing or eliminating the pain of endometriosis. One injection is given every 90 days in the doctor’s office. Progestin pills may be prescribed instead.

Lupron Depot^® works by suppressing hormonal signals from the pituitary gland in the brain to the ovaries, thereby curbing estrogen production and putting the body into temporary menopause. Injected monthly or every three months in the doctor’s office for six months or longer, Lupron Depot^® stops periods and can shrink endometrial implants. It may reduce or eliminate pain during treatment and afterward. Symptoms may sometimes subside for years, depending on the severity of endometriosis.

A synthetic form of the male hormone testosterone, danazol lowers estrogen levels and increases androgens, or male sex hormones, initiating a temporary menopause. This medication, given as a vaginal suppository, shrinks endometrial implants and stops periods, thereby reducing or eliminating pain. Danazol is frequently prescribed only as a last-resort hormonal treatment for severe endometriosis, used when other treatments do not alleviate symptoms.

Your doctor may suggest an over-the-counter oral pain medication, such as a nonsteroidal anti-inflammatory drug, to relieve mild pain caused by endometriosis. Sometimes steroids are injected, along with an anesthetic medication, into painful areas of the pelvis to relieve pain. These are called “trigger point injections.”