What is hormone therapy for endometriosis?

Hormone therapy (HT) can often relieve the symptoms of endometriosis. It can be used to reduce pain and bleeding. It may also shrink endometriosis growths (implants) and keep them from spreading.

HT prevents pregnancy, so it's not a good option if you want to get pregnant soon.

What are the types of HT?

Estrogen-progestin therapy plus a nonsteroidal anti-inflammatory drug (NSAID) are often used if symptoms are mild to moderate. If you have severe symptoms, or if estrogen-progestin therapy and NSAIDs don't relieve your symptoms, you may have other HT options. Talk to your doctor about the benefits and risks of the different types of HT.

• Estrogen-progestin therapy (birth control pills, patch, or ring) may reduce painful periods. It's less likely to cause serious side effects than other hormone treatments. It can often be used continuously for years, until pregnancy is desired or until the age of menopause. It is often used with NSAIDs. These include prescription medicines and over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve).
• Progestin-only therapy stops ovulation and lowers estrogen. It usually shrinks implants and reduces pain. Progestins are given as a shot or a pill. Or you may use the levonorgestrel intrauterine device (IUD).
• Gonadotropin-releasing hormone (GnRH) therapy lowers estrogen. It triggers a state that's like menopause. This shrinks implants and reduces pain in most cases. GnRH therapy can have more side effects than some other types of HT.
• Danazol therapy lowers estrogen levels and raises androgen (male sex hormone) levels. It triggers a state that's like menopause. It may shrink implants and reduce pain for several months after treatment. But danazol can have a lot of side effects.

How can you decide if you should take HT?

You might consider taking HT if:

• Your symptoms are mild to moderate.
• You don't want to get pregnant soon.
• You are close to menopause. Your estrogen levels will drop when your menstrual periods end. And you will probably stop having endometriosis symptoms.

You might decide not to take HT if:

• You want to get pregnant soon.
• You can manage your pain with other treatments.
• You want to avoid the possible side effects of HT.

Your doctor can help you weigh the pros and cons of HT so you can decide what's right for you.