Common names include:

• Leuprolide (Lupron Depot)
• Nafarelin Acetate (Synarel)
• Goserelin Acetate (Zoladex)

GnRH agonists block the release of hormones that cause ovulation. As a result, estrogen is not produced. This stops the menstrual cycle and helps to relieve the symptoms of endometriosis.

For women with endometriosis, GnRH agonists can have the following health benefits:

• Pain relief (by the 2nd or 3rd month)
• Shrinkage of the endometrial growths
• Delay of a recurrence of endometriosis after surgery
• Improved quality of life

A GnRH agonist can be given by injection or through a nasal spray. It is usually prescribed for six months or more. Side effects are common and can vary depending on the drug taken. They can be severe in some women.

Possible side effects include:

• Bone density loss
• Hot flashes and night sweats
• Difficulty sleeping
• Lowered sex drive
• Headache
• Muscle ache
• Nausea and vomiting
• Memory loss
• Fast heartbeat
• Changes in the skin and hair
• Dryness or burning in the vagina
• Gain or loss of weight
• Depression

Common names include:

• Danazol (Danocrine, Cyclomen)

Danazol is a synthetic androgen, which is a male hormone. Danazol helps relieve the symptoms of endometriosis by stopping reproductive hormones from being made and by stopping the menstrual cycle.

Danazol can have the following benefits:

• Pain relief
• Shrinkage of endometrial growths

Danazol is taken in pill form, typically three times per day for 6-9 months at a time. It is sometimes given with oral contraceptives to decrease possible side effects. Most of the side effects are due to the effects of the male hormone. Most are relatively mild and stop when treatment stops.

Possible side effects include:

• Increase in LDL (bad) cholesterol levels
• Changes in blood sugar levels
• Facial hair
• Weight gain
• Dandruff
• Deepening of the voice
• Decreased breast size
• Acne
• Oily skin
• Irritation in the vagina
• Hot flashes
• Mood swings

• Medroxyprogesterone Acetate (Depo-Provera)
• Norethindrone (Aygestin)
• Combined estrogen/progesterone oral contraceptives
• Progestin-containing Intrauterine Device: Levonorgestrel-releasing intrauterine system (Progestasert, Mirena)

Progestin is one of the hormones that is naturally released by the ovary during the menstrual cycle. Taken as medication, it stops ovulation and the menstrual cycle. Progestins can be very effective for controlling the symptoms mild to moderate of endometriosis. They can be given as long-term therapy and can be especially useful in women who do not want to become pregnant.

Progestins can have the following health benefits:

• Pain relief
• Improved quality of life
• Reduce recurrence of endometrial growths after surgery (combined birth control pills)

Progestins are taken in either pill form or by injection or by delivery from an intrauterine device. Injections are typically given once every three months. Progestin in pill form can be given as a progestin alone or as an estrogen/progestin-combined oral contraceptive. In pill form, it is taken once per day and should be taken at approximately the same time every day. If it causes nausea, it should be taken just before bedtime.

Possible side effects include:

• Irregular spotting
• Weight gain
• Mood swings
• Headaches
• Breast tenderness
• Acne

• Anasrozole
• Letrozole
• Exemestrane

Aromatase inhibitors may have a role in the future for treating endometriosis. In premenopausal women, such as women with endometriosis, aromatase inhibitor regimens require concimitant ovarian suppression with a GnRH agonist, progestin, or combined oral contraceptive. The most attractive combination is probably the oral contraceptive plus aromatase inhibitor. The side-effects are comparable to other treatments, but do not include the risk of bone density loss experienced with GnRH agonist.

Common names include:

• Ibuprofen (Advil, Motrin)
• Naproxen sodium (Aleve)

NSAIDs are pain relievers. If pain is expected (for example, during your menstrual period), these medications work best when taken on a schedule rather than an as needed basis. The dose depends on the amount of pain. For severe pain, NSAIDs are available in higher doses by prescription. These medications should be taken with food and a full glass of water.

NSAIDs are known to increase bleeding. If you are going to have surgery or a biopsy, tell your healthcare provider that you are taking these medications. Also they should be used with caution if you have a stomach ulcer, high blood pressure, kidney disease, or are taking blood thinners.