Medical Treatments for Endometriosis

Our doctors may prescribe oral contraceptives, also known as birth control pills, to women who aren’t planning to become pregnant soon. They may recommend that these contraceptives be taken continuously—meaning that the placebo pills are skipped, and that another package of birth control pills is started immediately. 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 (groups of endometrial cells) regrow. In some women, spotting or breakthrough bleeding occurs during the first few months of taking birth control pills but then typically subsides.

Progestin is a synthetic form of progesterone, a hormone that helps prepare the lining of the uterus to receive a fertilized egg. Progestin cause the uterine lining to thin and endometriotic implants to shrink, thereby reducing or eliminating the pain of endometriosis. Progestin comes in the form of oral medications, such as Norethindrone, or injectables, such as Depo-Provera.

Gonadotropin-releasing hormone blockers, known by the brand names Lupron Depot and Orilissa, work 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. Both medications stop periods and can shrink endometriotic implants. They can offer long-term pain relief, depending on the severity of endometriosis. If menopausal symptoms become hard to tolerate, they may improve with progestin or a low-dose estrogen replacement.

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 as a hormonal treatment for severe endometriosis, to be used only when other treatments do not alleviate symptoms.