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Progestins are the oldest drugs
used for endometriosis. Most can prevent ovulation and
reduce the risk for endometriosis because they include
luteinizing hormone (LH), one of the reproductive hormones
important in ovulation. Can change the lining of the uterus
and eventually cause it to atrophy. Provide temporary
pain relief comparable to the more powerful hormone drugs,
such as danazol or a GnRH agonist. Specific Progestins
like Medroxyprogesterone (Depo-Provera) is administered
by injection usually every three months, and are the standard
progestins used. Others can be tried such as norethisterone,
dienogest, and lynestrenol. A few of these progestins
may have fewer side effects than Depo-Provera. For example,
according to one study 94% of patients achieved some pain
relief from norethindrone (Aygestin, Norlutate), however,
7% dropped out because of side effects. A recent version
of the intrauterine device (IUD) called the LNG-releasing
intrauterine system (LNG IUS) releases progesterone which
may have specific benefits against endometriosis
Effects:
• Changes in uterine bleeding; higher amounts during
periods, spotting and bleeding between periods, or absence
of periods.
• Unexpected flow of breast milk.
• Abdominal pain or cramps.
• Diarrhea, Fatigue, unusual tiredness, weakness.
• Hot flashes.
• Decreased sex drive.
• Nausea.
• Trouble sleeping
• Acne or skin rash.
• Depression, irritability, and other mood changes.
• Swelling in the face, ankles, or feet.
• Weight gain.
Progestins used in contraceptives that work only in the
uterus, such as LNG-IUS IUD, may not pose as high a risk
for these side effects.
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