Table 2.
Medical treatment* for endometriosis
| Drug | Mechanism of action | Length of treatment recommended | Adverse events | Notes |
|---|---|---|---|---|
| Medroxyprogesterone acetate/progestagens | Ovarian suppression | Long term | Weight gain, bloating, acne, irregular bleeding | May be given orally or by intramuscular or subcutaneous depot injection |
| Danazol | Ovarian suppression | 6-9 months | Weight gain, bloating, acne, hirsutism, skin rashes | Adverse effects on lipid profiles |
| Oral contraceptive | Ovarian suppression | Long term | Nausea, headaches | Can be used to avoid menstruation by skipping the placebo pills |
| GnRH analogue | Ovarian suppression by competitive inhibitor of GnRH analogue | 6 months | Hot flushes, other symptoms of hypo-oestrogenism | By injection or nasal spray only |
| Levonorgestrel intrauterine system | Endometrial suppression; ovarian suppression in some women | Long term use but change every 5 years in women <40 years | Irregular bleeding | Also reduces menstrual blood loss |
GnRH=gonadotrophin releasing hormone.
*Decisions about medical therapy will depend on patient's choice, available resources, plans for fertility, and ongoing symptoms. Side effect profile may influence choice.