Types of Medication for Endometriosis

Endometriosis is a condition in which a mass of tissue outlining the uterus (endometrium) grows outside it, mostly in the ovaries, fallopian tubes (tubes present in the uterus), vagina, cervix, or intestine. It is an extremely painful condition that affects approximately 6%-10% of women of reproductive age in the United States.

Endometriosis initiates an inflammatory response, characterized by the formation of tumors on the site.

Usually, doctors may prescribe over-the-counter (OTC) painkillers to treat pain associated with endometriosis. Hormone therapies can also help ease endometriosis pain. Some of the commonly used medications for the treatment of endometriosis include the following:

1. Painkillers: These drugs relieve mild symptoms associated with endometriosis. Some examples include:
   • Ibuprofen
   • Naproxen
2. Hormone therapy: Hormones when given as supplements can be effective in reducing or eliminating pain associated with endometriosis. These are prescription medicines that delay endometrial tissue growth and prevent new implants of endometrial tissue. They work by balancing hormone levels. Some examples include:
   • Hormonal contraceptives like birth control pills, vaginal rings, and patches
   • Gonadotropin-releasing hormones (GnRh) agonists like goserelin, leuprolide, and nafarelin and antagonists like elagolix
   • Progestin therapy including an intrauterine device with levonorgestrel, the contraceptive implant (Nexplanon), contraceptive injection (Depo-Provera), or progestin pill (Camila)
   • Androgen receptor agonist like danazol
   • Aromatase inhibitors like letrozole and anastrozole

Oral contraceptives and progestin therapy are commonly prescribed as first-line therapy for relieving pain associated with endometriosis. GnRH analogs have more side effects than other therapies and are prescribed as second-line drugs.

Common side effects of painkillers include:

• Ulcers
• Bleeding in the stomach or intestines
• Stomach pain
• Constipation
• Nausea
• Trouble concentrating

Common side effects of hormonal contraceptives include:

• Nausea
• Breast tenderness
• Irregular vaginal bleeding or "spotting" between periods

Common side effects of GnRh include:

• Hot flashes
• Vaginal dryness
• Decreased libido
• Insomnia

Common side effects of progestin therapy include:

• Weight gain
• Depression
• Acne
• Body hair
• Irregular bleeding

Common side effects of danazol include:

• Decrease in the breast size
• Irregular menstrual periods
• Weight gain

Common side effects of aromatase inhibitors include:

• Hot flashes
• Night sweats
• Vaginal dryness

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Most hormone therapy drugs should be avoided during pregnancy. It is generally not safe to take contraceptives or use intrauterine devices during pregnancy. Although there is no known harm to the mother and fetus, these therapies are not recommended during pregnancy. You may take OTC painkillers after approval by your physician or midwife.

You can also manage your pain by:

• Performing gentle stretches and yoga
• Using heat pads or warm baths to ease cramps
• Eating foods rich in fiber to prevent constipation

Drugs used to treat endometriosis may interact with alcohol and cause unwanted reactions. Alcohol can also worsen the symptoms of endometriosis due to:

• Increased estrogen levels
• Increased insulin resistance

Consult your doctor about the drinks allowed when you have endometriosis.