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Dr. Cook’s Guide to Hormone Therapy Treatments for Patients with Pelvic Pain

Introduction

The typical medical treatment for endometriosis provided by most OB/GYN’s basically is manipulating a woman’s hormones, primarily her estrogen and/or progesterone levels. The concept behind this approach to treatment of endometriosis is that estrogen tends to stimulate the growth of endometriosis and progesterone balances or stabilizes the effect of estrogen. In a very simple example, one can think of estrogen as fertilizer for the lawn and progesterone as the lawn mower. The goal of medical treatment of endometriosis is to increase the ratio of progesterone to estrogen (progesterone only treatment), decrease the amount of both estrogen and progesterone (combinational birth control pills) or to eliminate estrogen from the body (GnRH treatments such as Lupron).

Unfortunately, all of the medical treatment options for endometriosis treatment are fairly crude, commonly with unacceptable side effects. The medical treatments do not provide a cure for the disease, only work for a portion of endometriosis patients and even when the treatment option is effective the results are only temporary. Even use of a GnRH agonist such as Lupron that cause a temporary medical menopause may not be effective in treating endometriosis as the actual lesions of endometriosis can produce their own estrogen and remain active and potentially invasive despite ovarian suppression.

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