Hormone therapy endometriosis

Norethisterone Synthetic progestogen Abnormal uterine bleeding. Endometriosis, component of some oral contraceptives and in hormone replacement therapy... 

The major uses of progestogens are for hormone replacement therapy and for hormonal contraception where they suppress ovulation and make the cervical mucus impenetrable to spermatozoa. Other indications include secondary amenorrhea, dysmenorrhea, infertility and habitual abortion and endometrium suppression in endometriosis. Progestogens are also used for palliation in metastasized endometrial and breast carcinoma. Medrogestone has been used in the treatment of fibroid uterine tumors. 

It is indicated as contraceptive, in hormone replacement therapy, primary and secondary amenorrhoea, dysfunctional uterine bleeding, endometriosis, postponement of menstruation, premenstrual syndrome, uterine hypoplasia, threatened or habitual abortion and premenstrual tension. It is also useful in endometrial carcinoma. 

Moghissi KS, Schlaff WD, Olive DL, Skinner MA, Yin H. Goserelin acetate (Zoladex) with or without hormone replacement therapy for the treatment of endometriosis. Fertil Steril 1998 69(6) 1056-62. 

Pierce SJ, Gazvani MR, Farquharson RG. Long-term use of gonadotropin-releasing hormone analogues and hormone replacement therapy in the management of endometriosis a randomized trial with a 6-year follow-up. Fertil Steril 2000 74(5) 964-8. 

Women with endometriosis receive treatment courses of 6 months duration. Concomitant low-dose hormone replacement therapy has been reported to diminish bone loss without significantly decreasing clinical effectiveness. Women with uterine fibroids that are symptomatic (menorrhagia, anemia, pain) receive treatment courses of 3 months, by which time women have amenorrhea or reduced menorrhagia uterine fibroids are reduced in size an average of 37%. Intramuscular depot preparations containing 3.75 mg (monthly) or 11.5 mg (every 3 months) are used. 

Tahara M, Matsuoka T, Yokoi T, Tasaka K, Kurachi H, Murata Y. Treatment of endometriosis with a decreasing dosage of a gonadotropin-releasing hormone agonist (nafarelin) a pilot study with low-dose agonist therapy ( draw-back therapy). Fertil SterU 2000 73(4) 799-804. 

All medical therapies (nonsteroidal anti-inflammatory drugs, oral contraceptives, progestins, danazol, or gonadotropinreleasing hormone agonists) are equally efficacious in treating endometriosis-related pain based on available evidence. Choice among agents is determined primarily by side-effect profile, cost, and individual patient response. 

Surrey ES. Add-back therapy and gonadotropin-releasing hormone agonists in the treatment of patients with endometriosis Can a consensus be reached Add-Back Consensus Working Group. Fertil Steril 1999 71 420-424. 

A woman s reproductive life cycle spans nearly four decades. During this time her hormonal status and ability to reproduce vary considerably. The need for hormonal intervention during this time period varies from person to person and, typically, requires highly individualized medication regimens. The remainder of this chapter will focus on hormonal and selected nonhormonal therapies for the treatment and/or management of contraception, endometriosis, infertility, menopause, and breast cancer. 

Her medieal history was positive for high blood pressure, asthma that was usually only bothersome when around dust, molds, or strong odors, and a hystereetomy and oophorectomy at age 38 for endometriosis. She had previously had a fractured wrist at age 68 after a fall when she tripped going up the stairs. Medications she was using included atenolol, a salmeterol xina-foate inhaler twice daily, and occasional courses of prednisone when the asthma was more severe. She had used hormone replacement therapy for 4 years after the gynecologic surgery, but none since then. 

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