If you have symptoms and pain, the most obvious goal of treatment is to prevent the pain and progression of endometriosis, either through alternative approaches (discussed under “Flower Power”) or with conventional approaches such as hormonal therapy or surgical removal of the endometrial “pieces.” Since endometriosis typically improves during pregnancy and after menopause, creating either a pseudopregnancy with oral contraceptives or a pseudomenopause with danazol are standard treatments.
Many women find that oral contraceptives can stop the progression of endometriosis and can treat it. Harsher hormonal therapies include danazol (a derivative of testosterone), which induces menopause and also causes what’s known as androgenic side effects, such as acne, weight gain, unwanted hair, hot flashes, reduced libido, oily hair and skin, nausea, and lowering of the voice. Danazol has also been linked to immune suppression, which can trigger autoimmune diseases. Gonadotropin-releasing hormone (GnRH) is another standard therapy, which is a “copy” of your natural GnRH and shuts it down. The three analogs used to treat endometriosis are leuprolide acetate (an injection), nafarelin acetate (a nasal spray), and goserelin acetate (a subdermal implant). GnRH therapy works in 75 to 92 percent of women with endometriosis.
Treatment with a progestin drug is commonly done as well; the progestin that is most commonly used for endometriosis is medroxyprogesterone. In the United States, the dosage is usually 20 to 30 mg per day for up to six months. Sometimes just taking pain relievers with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can manage the symptoms without necessitating hormone therapy.
