Should You Treat Your Endometriosis With Hormone Therapy?
e still not sure what causes endometriosis, but
it is clear that the female sex hormone estrogen, which stops
being produced during menopause, feeds the growth of abnormal
endometrial tissue.
Unfortunately, for most young teens and women in their
reproductive years, menopause is still many years away, which
means they are left to deal with the painful symptoms of
endometriosis, with no relief in sight. Thus, what is often
recommended for many non-menopausal women is hormone therapy.
Hormone therapy is one of the most successful treatments for
endometriosis, as it helps around 80-90% of the women who take
it. Hormone therapy controls estrogen, helping to alleviate
pain caused by endometriosis. It can also reduce the size and
amount of endometrial implants, stopping endometriosis from
spreading.
However, it is important to note that hormone therapy does not
improve a woman’s fertility. Therefore, if you are concerned
about infertility or wish to become pregnant, these therapies
are not an option for you. Moreover, young teenage girls, who
have not reached the end of puberty, are usually unable to take
this form of treatment, as it poses a risk to their development.
In addition, there are various types of hormone therapy and
each woman responds to treatment differently. Furthermore, like
taking any medication, there are always pros and cons that need
to be carefully considered.
The following is information about the most popular forms of
hormone therapies used to treat endometriosis:
Birth control pills - This is the most popular therapy and is
considered safe to use for long term use. A woman can generally
use it until menopause. Birth control pills are designed to
control menses and stop ovulation. Without ovulation,
endometrial implants can no longer grow and will shrink.
Birth control pills lower the risk of ovarian cancer, and are
generally safe for most women. This therapy is available in
pill, skin patch or vaginal ring form. It has few negative side
effects including headaches, nausea, breast tenderness,
depression, mood swings, and irregular, light or absent menses.
It also increases the risk of blood clots and slightly increases
the risk of breast cancer.
Gonadotropin-releasing hormone agonist (GnRH-a) - This therapy
decreases estrogen levels to those experienced after menopause,
and can only be taken for the short term (no more than 6
months). GnRH-a increases the risk of bone loss, which can
cause osteroporosis, and is why it is usually taken with
progestin to help prevent thinning of bones and other
menopausal symptoms. GnRH-a is often used to help prolong the
relief of endometriosis pain after surgery, as it works to
prevent the return of endometriosis.
High dose progestin - This therapy is taken in the form of
pills or a shot. It is designed to produce progestin levels in
the body that mirror pregnancy. This therapy ceases monthly
ovulation, and decreases estrogen which allows endometriosis
growths to shrink, alleviating pain in most women. Progestin
can be taken for long term (usually no more than 2 years).
The side effects of progestin include depression, bloating,
breast tenderness, weight gain, light or absent menses, risk of
bone loss if taken for longer than 2 years, and fertility can
take up to a year or longer before it returns.
Danazol - This therapy decreases estrogen levels and increases
the level of androgen (male) hormones. Danazol also puts the
body into a menopause-like state. Although it effectively
shrinks endometrial growths and reduces pain, its side effects
can include muscle cramps, weight gain, acne, skin rash, oily
hair and skin, decrease in breast size, facial and body hair,
and even voice deepening. To make matters worse, most of these
male-transforming side effects can be permanent.
Danazol is often short term therapy, and is usually the last
doctors will recommend.
Talk to your doctor to find out if hormone therapy is right for
you.
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