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Injection (into a muscle or under the skin)
One injection is given every 90 days.
Intrauterine device (IUD) with progestin
Megestrol and Depo-Provera are high-dose progestins.
shrinks endometriosis growths—which are also called implants—and reduces pain
for most women.
Progestin is similar to the body's hormone
progesterone. Taking progestin creates levels in the
body similar to pregnancy. This stops monthly growth of the uterine lining
endometriosis implants elsewhere in the body.
Progestin also reduces
estrogen production, which stops
ovulation and menstrual periods in most women.
levonorgestrel (LNg) intrauterine device (IUD) is used to treat endometriosis. It releases a lower daily dose of levonorgestrel, a form of progestin, directly
into the uterus. This causes fewer side effects than high-dose progestin pills
or injections. In addition to reducing cramping and heavy menstrual bleeding,
the LNg IUD is a highly effective method of birth control.
Progestin is a second-choice
treatment for endometriosis. It is as effective as other hormone therapies. But
it is typically used after birth control pills and/or
gonadotropin-releasing hormone agonist (GnRH-a) therapies have not relieved
endometriosis pain. This is because high-dose progestin, when given by mouth or injection, may cause bone-thinning and unpleasant side
effects.1 (Megestrol and Depo-Provera are high-dose
progestins. The progestin IUD is not known to have effects on the bone and
causes fewer side effects because the progestin dose is lower.)
Progestin injection and the LNg IUD also effectively prevent
Like all hormone therapies and
surgery, progestin does not cure endometriosis.
Progestin may improve symptoms of
endometriosis, such as pain during periods and pelvic pain. When
compared with other hormone therapies, it has proved to be equally effective.
Generally about 80% to 90% of women gain relief with any particular hormone
After GnRH-a treatment, or any
other hormone therapy, endometriosis pain can return.1
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call 911 or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of this medicine include:
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
Progestins may cause bone loss. This usually improves after stopping the medicine.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Fritz MA, Speroff L (2011). Endometriosis. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1221–1248. Philadelphia: Lippincott Williams and Wilkins.
May 14, 2012
Adam Husney, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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