Hormone Therapy for Endometriosis
Along with surgery, hormone therapy is one of the most important building blocks in treating endometriosis. The aim is to dampen the body's own oestrogen production or suppress the cycle – endometriotic lesions react to hormonal changes just like the uterine lining and grow under the influence of oestrogen.
Commonly used preparations include progestins such as dienogest, the combined pill, a hormonal coil, or – in certain situations – GnRH agonists or antagonists. Which preparation is suitable depends, among other things, on symptoms, age, and whether pregnancy is desired.
Hormone therapy is also often continued for a few months after surgery, to delay the recurrence of endometriotic lesions.
Important information:
A well-established part of endometriosis treatment
Hormone therapy suppresses the hormonal stimulation of endometriotic tissue, which can significantly relieve pain and reduce the risk of it growing back. It is often the first line of treatment before surgery is considered.
Which hormone preparations are used?
- Progestins, e.g. dienogest
- Combined pill (oestrogen + progestin)
- Hormonal coil (local progestin release)
- GnRH agonists/antagonists – for more severe symptoms, used for a limited time
Effectiveness and outlook
In most women, hormone therapy noticeably relieves typical endometriosis pain. Existing lesions may shrink, but hormones alone usually cannot eliminate endometriosis completely.
Possible side effects
Depending on the preparation, breakthrough bleeding, mood swings, headaches, weight changes, or a temporarily reduced build-up of bone density (particularly with GnRH analogues) can occur. Pregnancy is usually not possible during hormone therapy – this should be taken into account if you wish to conceive.
Alternatives & next steps
If the effect is insufficient, side effects are severe, or you wish to become pregnant, laparoscopic endometriosis surgery may be advisable. Which combination of hormone therapy and surgery is right for you is decided together with your treating specialist.
Frequently Asked Questions
Frequently asked questions about hormone therapy for endometriosis.
How quickly does hormone therapy work?
Many women notice pain relief within the first few months. It can take several cycles, however, for the full effect to develop.
Can I get pregnant while on hormone therapy?
Most hormonal endometriosis therapies suppress ovulation and therefore also act as contraception. If you wish to have children, be sure to discuss this with your doctor.
How long does treatment last?
Hormone therapy is often continued for several months to years, sometimes as long-term treatment – particularly if pregnancy is not currently desired.
Does hormone therapy replace surgery?
Not necessarily. In cases of severe findings, organ involvement, or an unfulfilled desire to have children, laparoscopic surgery may also be advisable or necessary.
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