The GnRH class of drugs is becoming
more widely used to control the pain of endometriosis.
GnRH stands for Gonadotropin Releasing Hormone. These
drugs are not without side effects, but in most women
the side effects are either bearable or manageable. Effectiveness
depends on each woman's level of tolerance and the degree
to which a particular drug affects the individual. Many
of these GnRH agonists are only available in long-term-release
injectable form (i.e., the drug stays in the body for
a month or so) each woman should carefully consider the
pros and cons of this type of therapy. At this time, gonadotropin
releasing hormone (GnRH) agonists are the most effective
hormone treatments for endometriosis. They are able to
block the release of the reproductive hormones LH (luteinizing
hormone) and FSH (follicular-stimulating hormone). As
a result, the ovaries stop ovulating and no longer produce
estrogen. They relieve pain in most patients by the second
or third month.
Effects:
• Can throw the body into a chemically induced menopausal
state to provide time for endometriosis lesions to shrink.
• Effective for most women for the relief of pain
and temporary shrinking of this disease.
• Most common side effects are hot flashes, with
about 95% of patients experiencing them sometime during
therapy.
• Headaches, which are usually manageable with minor
analgesics such as ibuprofen.
• Short-term memory loss, but studies have shown
that in most cases this problem is resolved after treatment
is finished.
• Vaginal dryness due to decreased estrogen levels
is also frequently reported, but this problem is almost
always manageable using over-the-counter lubricants that
are found in drugstores.
• Smaller numbers of women report side effects such
as depression, moodiness, weight gain, and others.
A monthly injection of leuprolide (depot Lupron), or Nafarelin
(Synarel) as a nasal spray. Studies have reported that
nafarelin shrank all implants and significantly relieved
symptoms in 85% of patients, delayed recurrence of endometriosis
after surgery, and in comparison with leuprolide, was
less expensive, had fewer side effects, and a resulted
in better quality of life.
Warning: GnRH Agonist may prevent young women from reaching
peak BMD. Because GnRH agonist therapy is associated with
reduced bone mineral density (BMD). If you are a young
woman, treatment with GnRH agonists for Endometriosis
may result in you never achieving peak BMD, and may increase
your risk for osteoporosis later in your life.
Danazol
Danazol is a synthetic testosterone derivative and is
similar to the GnRH agonists in that it decreases estrogen
in the body, shrinks endometriosis lesions and relieves
pain. Danazol is used for up to 6 months and then must
be discontinued.
Effect.
• Acts like the male hormone testosterone, it has
many androgenic side effects.
• Acne, reduction in breast size, weight gain, abnormal
facial and body hair growth. Most of these are considered
temporary, but a few may be permanent.
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