Hormone therapy treatments

Usually when presenting abnormal symptoms around the menstrual cycle, your doctor will advise you to try hormone therapy treatments.

 

These treatments are usually given to help with bleeding control and irregularities, making periods lighter or stopping them altogether and preventing you from getting pregnant.

 

However, not all hormone treatments protect against pregnancy, and they do not protect against sexually transmitted diseases (STD). You should ask your doctor whether additional contraception is required.

 

Will hormone treatments work for me?

 

If you decide to give hormone treatments a try, there is a chance your symptoms may improve.

 

We recommend a 3–6-month trial period and if your symptoms persist and your pain does not subside and your doctor suspects you might have Endometriosis, it is important at this point you are referred onto secondary care.

Your doctor will work with you to determine which treatment is best suited to you, taking into consideration your age, medical history, whether you’re looking to start a family, and various other individualised circumstances, along with any possible side effects, risks, and complications.

Your doctor may also advise you to take hormone treatments in the lead up to surgery or after removal of Endometriosis.

Are there side effects?

Whilst hormone treatments can help, unfortunately they do not work for everybody, there are side effects and sadly, they cannot cure Endometriosis.

Side effects may include:

  • Low mood

  • Headaches

  • Irregular bleeding

  • Breast pain

  • Bloating

  • Weight gain

  • Oily skin

  • A decrease in bone density

  • less commonly, an increased risk of developing a blood clot in the legs or lungs

Take a look below at the most frequently used forms of hormone therapy treatments:

The mini pill

The mini pill (also known as progestin-only birth control) is a type of synthetic hormone usually given in pill form, it can also be given via an injection, Mirena IUS or implant. Progestin-only birth control contains a small amount of progesterone. This type of treatment contains no oestrogen. It is used to prevent ovulation, making your periods lighter and less painful.

The combined contraceptive

The combined contraceptive can be given in pill form or patch, and it is usually advised to be taken continuously without having a typical ‘period break’. This type of treatment contains both oestrogen and progesterone. It is given to prevent ovulation, causing periods to become lighter and less painful or stop altogether.

The Mirena intra uterine system (IUS)

The Mirena coil (IUS) is an intrauterine device which carries a hormone called levonorgestrel. This is a type of progesterone given to make periods lighter and less painful. It comes in a plastic T-shaped device which is inserted into the uterus through the cervix by a specially trained doctor. You are usually awake during this procedure, however you may choose to have the coil inserted during surgery, after removal of Endometriosis.

The Mirena coil is a popular choice for people with Endometriosis as it can last for up to 5 years and once settled, it can temporarily stop your periods altogether.

The Contraceptive injection

This is a type of progesterone given in the form of an injection which is usually inserted into either the bottom or upper arm. The contraceptive injection is normally administered within the first 5 days of your cycle and each injection can have a lasting effect for up to 12 weeks. This treatment is given to prevent ovulation, causing periods to become lighter and less painful, some may not experience periods at all.

GnRH Analogues

GnRH Analogues (gonadotrophin-releasing hormone agonists) are a group of hormonal regulating treatments given in the form of an injection, pill, implant, or nasal spray.

They go by the name of:

  1. Goserelin (Zoladex)

  2. Leuprorelin (Prostap, Lupron)

  3. Triptorelin (Decapeptyl)

  4. Nafarelin (Synarel)

  5. Buserelin (Suprecur)

 

These treatments are given to essentially stop your periods by forcing your body into a sudden, immediate (but temporary) menopause (known as medical menopause).

Upon administration, it is not uncommon to experience an initial surge in symptoms. You may also experience some menopausal side effects, these include:

  • Hot flushes

  • Cold sweats

  • Vaginal dryness

  • Itchy skin

  • Low mood

  • Depression

  • Trouble sleeping

  • Low libido

  • Bone pain

  • Hair thinning

 

GnRH Analogues are also known for reducing bone density resulting from oestrogen deficiency. For this reason, this treatment is not advised for those under the age of 16. It is also recommended for use of no longer than 6 months at one time. 

To help reduce these side-effects and prevent against bone thinning, you may be offered a form of hormone replacement therapy (HRT).

Hormone replacement therapy (HRT)

Hormone Replacement Therapy (HRT) is given to replace the important hormones your ovaries would have naturally produced to allow you to function and feel well. The type of HRT given will depend on the treatment you have and how severe your Endometriosis was or may be.

HRT can also help with the menopausal side effects by reducing symptoms and protecting against bone health. The side effects will usually disappear over time with the help of HRT, however such side effects, including the loss of bone mineral density, may not return to normal and because of this, you may be at risk of developing Osteoporosis (brittle bone syndrome).

Your GP or medical team will advise whether regular bone density scans are required to check for any possible signs of thinning bones.

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