Oral contraceptives hormonal endometriosis

Thus, our attention should shift from the concern of potential adverse effects to the health benefits imparted by hormonal contraceptives. The use of oral contraceptives for at least 12 months reduces the risk of developing endometrial cancer by 50%. Furthermore, the risk of epithelial ovarian cancer in users of oral contraceptives is reduced by 40% compared with that on nonusers. This kind of protection is already seen after as little as 3-6 months of use. Oral contraceptives also decrease the incidence of ovarian cysts and fibrocystic breast disease. They reduce menstrual blood loss and thus the incidence of iron-deficiency anemia. A decreased incidence of pelvic inflammatory disease and ectopic pregnancies has been reported as well as an ameliorating effect on the clinical course of endometriosis. 

The progestins are used in the treatment of amenorrhea, endometriosis, and functional uterine bleeding. Progestins are also used as oral contraceptives, either alone or in combination with an estrogen (see the Summary Drug Table Female Hormones and Table 52-1). 

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

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. 

Vercellini P, Trespidi L, Colombo A, et al. A gonadotropin-releasing hormone agonist versus a low-dose oral contraceptive for pelvic pain associated with endometriosis. Fertil Steril 1993 60 75-79. 

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