Hormone therapy is a medical treatment whereby the body’s natural hormones are suppressed, supplemented or replaced either by synthetic or bioidentical hormones, or by hormone agonists or antagonists (which affect the amounts of certain hormones produced by the body itself). Hormone therapies are used for a variety of reasons, from managing heavy, irregular or painful periods to reducing the symptoms commonly associated with menopause. Certain hormone therapies, such as the combined birth control pill and the Mirena intrauterine dinstevice, are commonly used for contraceptive purposes although may be used therapeutically to regulate menstruation, reduce menstrual pain and bleeding, and to treat premenstrual syndrome.
We appreciate that hormone therapies at best reduce the symptoms of endometriosis and do not treat the disease itself. Hormone therapy is only effective in some patients and may be poorly tolerated due to considerable side effects. Many of the women who come to us for treatment of their pelvic pain have already tried multiple courses of hormone therapy without relief and are looking for treatment of the underlying disease rather than mere symptom suppression. Surgery to meticulously remove all areas of endometriosis is often required to offer long-term relief. In many patients, there may be no need for post-operative hormone therapy following complete excision of their endometriosis (other than for contraceptive purposes or to manage the symptoms of uterine disease, such as adenomyosis).
Any decisions about hormone treatment are made on an individualized basis with the patient at the center, carefully considering and discussing her needs and preferences.