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The goal of hormonal treatment is to simulate pregnancy or menopause, two natural conditions known to inhibit the disease. In each case, the normal endometrium is no longer stimulated to grow and regress with each monthly cycle, and menstruation ceases. The growth of misplaced endometrial tissue usually will be suppressed as well.
To simulate the hormonal environment of pregnancy, birth control pills are prescribed. To be effective against endometriosis, the pills must be taken continuously without pausing for withdrawal bleeding. This state is sometimes called "pseudopregnancy".
The hormone derivative danazol is the medication most frequently used to treat endometriosis. During treatment with danazol, estrogen levels are reduced to low levels, which are characteristic of natural menopause. This state is sometimes called pseudomenopause. Danazol is an expensive medication that is usually prescribed for six months or more. Unfortunately, large endometriotic cysts of the ovary are generally resistant to the drug.
Analogues of GnRH, the gonadotropin-releasing hormone, are the newest class of hormones used for endometriosis treatment. These analogues switch off production of FSH and LH from the pituitary, thus inducing a menopausal state. These analogues can be given in the form of special injections called depot preparations, which release small quantities of the drug daily, allowing administration at monthly intervals.
Medical therapy used to be prescribed in the hope that it would cause the endometriosis to shrink sufficiently so that it would no longer interfere with conception after the treatment is stopped. However, since pregnancy cannot occur during the medical therapy of endometriosis, and because the treatment has been shown not to be helpful in improving fertility, medical therapy for endometriosis is no longer advised for infertile patients.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
