Medicines to Treat Endometriosis

Definition

Endometriotic disease, better known as endometriosis, is a morbid condition typical of the fertile age, which is characterized by the growth of an ectopic endometrial tissue.

Causes

Despite the clinical interest in the pathology, endometriosis still remains an unknown for many scholars: in fact, the triggering causes are not yet clear. Currently, we only have not fully demonstrated theories on the etiology of endometriosis.

Symptoms

Painful and annoying symptoms related to endometriosis: alterations in the menstrual cycle (dysmenorrhea, menometrorrhagia, menorrhagia), abdominal cramps, diarrhea, dyspareunia, severe pain in the lower abdomen, constipation and subfertility.

Complications: oozing of blood during menstruation → local irritation, scar lesions, adhesions between various organs

The information on Endometriosis - Endometriosis Treatment Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Endometriosis - Endometriosis Treatment Drugs.

Medicines

Before starting a drug treatment, it is recommended to wait 6-12 months, as spontaneous healing is possible. However, for women with endometriosis who do not witness a spontaneous regression, medical drug or surgical therapy is recommended (in the most severe cases).
The treatment of endometriosis is essentially based on the use of drugs with anti-estrogenic activity, useful for atrophying the ectopic endometrium.

The following are the classes of drugs most used in the therapy against endometriosis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

SUMMARY ANALOGS OF "LH-RH:

It is the first choice therapy for the treatment of endometriosis. These drugs work by blocking the secretion of some pituitary hormones, thus inhibiting estrogen synthesis by the ovary.

Leuprorelin (eg Enantone, Eligard): indicated in case of genital and extra-genital endometriosis. It is recommended that 11.25 mg of the drug be administered intravenously once every three months; alternatively, it is possible to administer the substance subcutaneously, at a posology of 3.75 mg as a single dose in the first 5 days of menstruation, and then take the drug every month for a maximum of 6 months. Furthermore, it is possible to administer the drug by intramuscular injection at a dosage of 11.25 mg as a single dose in the first 5 days of the menstrual cycle, then every 12 weeks (maximum duration: 6 months).
Goserelin (eg Zoladex): indicated to alleviate the symptoms of endometriosis (reduction of pain and lesions of the endometrium) at a dosage of 3.6 mg of drug subcutaneously (application to the abdominal wall). 3.6 mg can be repeated every 28 days, as indicated by the doctor. Generally, the application should be repeated 6 times (ideal total duration of therapy: 6 months).
Triptorelin (eg. Gonapeptyl-Depot, Fertipeptil, Decapeptyl) administered by intramuscular injection 11.25 mg of drug every three months. Alternatively, administer 3 mg of the drug every 4 weeks.
Leuprolide (eg Lupron): in case of endometriosis, it is recommended to take 3.75 mg of the drug intramuscularly once a month for six months; alternatively, take 11.25 mg of leuprolide every 3 months.

DERIVATIVES OF PROGESTERONE

PROGESTINICS → are widely used in therapy in order to induce a progressive, albeit slow, reduction of the ectopic endometriotic tissues, until complete atrophy of the same is obtained.

Norethindrone (eg Activelle): the recommended dose for the treatment of endometriosis is one 5 mg tablet per day for 2 weeks. The dosage can be increased by 2.5 mg per day for two weeks, up to a max. of 15 mg per day Therapy can be continued for 6-9 months, according to the doctor's instructions.
MEDROXYPROGESTERONE (eg. DEPO PROVERA, FARLUTAL, PROVERA G): the drug is available in the form of film-coated tablets of 5 - 10 mg of medroxyprogesterone. It is recommended to take one tablet once a day, as an addition to estrogen replacement therapy (which must be started on day 1 or 16 of each cycle, and continued for 12-14 consecutive days per month. Alternatively, take 2.5 mg per day orally during estrogen replacement therapy). The posology just described is useful, in particular, for the prophylaxis of atrophic endometriosis. For the treatment of the disease, it is recommended instead to administer 104 mg of the drug subcutaneously, once every three months, respecting the indications dictated by the doctor.

DERIVATIVES OF ANDROGEN HORMONES (gonadotropin antagonists)

They carry out their therapeutic activity by reducing the blood levels of estrogen and progesterone (inhibition of ovulation), thus causing the ectopic endometrium to atrophy.

Danazol (eg Danatrol): it is recommended to take the drug at a dosage of 100-200 mg per day orally. In case of severe endometriosis, the dose can be increased up to 400 mg, to be taken twice a day. For most patients, drug therapy is effective when it is continued for 3-6 months, or even 9 when it comes to a particularly severe endometriosis. Danazol is currently registered in Italy for the treatment of endometriosis.
Gestrinone (eg. Dimetrose): in case of endometriosis, gestrinone must be taken at a dosage of 2.5 mg twice a week (start of therapy: first day of the cycle). Take the second dose three days after the first administration of the drug, repeating the assumption always on the same days of preference (it is recommended to take gestrinone at approximately the same time and on the same days established each week). Generally, therapy should be continued for 6 months.

COMBINED ESTROGENS: by blocking ovulation, the risk of endometriosis is considerably reduced, ensuring a certain “endometrium protection” up to 12 months after the drug is stopped.

Ethinylestradiol / Levonorgestrel (eg Loette, Microgynon, Miranova, Egogyn): these are contraceptive pills useful for inhibiting the overproduction of gonadotropins, therefore also indicated in the treatment of endometriosis. These drugs are available in packs of 21-28 tablets: each tablet consists of 0.02 mg of ethinylestradiol and 0.1 mg of levonorgestrel. Pharmacological treatment involves taking one tablet a day, for 21 days, possibly at about the same time each day, followed by a free interval of one week.
Desogestrel / Ethinylestradiol (eg Gracial, Novynette, Lucille, Dueva, Securgin): these are coated tablets of 20 mcg of ethnylestradiol and 150 mcg of desogestrel. The posology of these drugs reflects the one described above: the correct way of taking these active ingredients guarantees a significant reduction in symptoms related to endometriosis, as well as a clear improvement in the patient's clinical profile.