by drseckin.com | Posted on April 12, 2021
Endometriosis is a disease where tissue resembling the endometrium (the inner lining of the uterus) grows in other parts of the body. It is most commonly found in the pelvic region . Like the endometrium found in the uterus, this tissue also responds to female sex hormones, estrogen and progesterone, which play an important part in the menstrual cycle .
Doctors often prescribe combined oral contraceptive (COC) pills to regulate the menstrual cycle as well as the symptoms of endometriosis .
Combined oral contraceptives (COCs) have been in vogue for many years for the symptomatic management of endometriosis despite the lack of concrete evidence of efficacy as they are inexpensive and are generally well-tolerated .
Endometriosis is an estrogen-dependent disorder . Estrogen given unopposed (without progesterone) can promote the growth of endometrial tissue leading to inflammation and pain. The COC contains both estrogen and progestin (the synthetic form of progesterone), which counters the effects of estrogen. Although COCs may help with painful symptoms of endometriosis, it is thought that estrogen dominance (estrogen having a greater effect than progesterone) may still occur when taking COCs, thus not helping with regression of endometriosis lesions, and in some cases with continuing progression of the disease .
COCs are also limited in their applicability. They are not suitable for women over age 35 who smoke, women at increased risk of stroke, heart attack, and blood clots, and those taking certain medications .
Research suggests that progestin-only pills are a better alternative to COCs to manage the symptoms of endometriosis as they do not contain estrogen .
The continuous administration of progestins at higher doses than the COC also stops regular periods and reduces the chances of breakthrough bleeds. Progestins also have anti-inflammatory properties, which is helpful in alleviating inflammation and pain associated with endometriosis .
Finally, another advantage of progesterone-only pills is that they can be used at any age to stop menstruation with few side effects and without the risk of internal clots .
Please note that the “mini-pill”, while progestin-only, is only a contraceptive pill that works by thickening cervical mucus and may not help to the same extent with pain symptoms and also does not suppress the menstrual cycle or stop ovulation. The mini-pill is at a dose that is 10 times lower than progesterone-only therapies for endometriosis.
Progestin-only treatments are available as pills, injections, and intrauterine devices.
Norethindrone and medroxyprogesterone are oral pills and medroxyprogesterone are also available as an injection.
Progesterone pills are usually taken daily and at the same time, every day whereas injections are given once every three months.
Levonorgestrel is another progestin that is available both as a pill and as a small, T-shaped intrauterine device. The device can release medication for up to five years .
Danazol is a synthetic male hormone or androgen that can also be used to manage endometriosis . Danazol lowers estrogen levels and prevents the growth of endometrial tissue. However, it is not used commonly any longer as it comes with the risk of severe side effects including weight gain, changes in menstrual cycles, and other androgenic effects such as excess hair growth in a male pattern.
Leuprolide acetate (leuprorelin, or Depo Lupron) is an injection that is given every one or three months to treat endometriosis. Leuprolide interferes in the signaling that tells the ovaries to make estrogen and thus lowers natural estrogen levels inhibiting the growth endometriosis . Essentially, it tells the brain to stop sending messenger hormones (follicle-stimulating hormone and luteinizing hormone, FSH and LH) to the ovaries, thus creating a state of pseudo-menopause. However, the continuous administration of leuprorelin can lead to side effects such as hot flashes, vaginal dryness, and low bone mineral density with a risk of fracture . Therefore, leuprorelin is often supplemented by hormonal “add-back” therapy in which a progesterone pill is administered alongside to offset the side effects and prevent endometriosis progression at the same time .
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There aren’t enough stars for Seckin Endometriosis. They deserve 100/ 5. I want to make sure every woman right now who is looking for help, who is looking for a doctor and is scared and confused knows this is where you need to be. It doesn’t matter if you have to come from the other side of the United States or from the other side of the world, I can guarantee it will be worth it. Every member of their…
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Dr.Seckin is so much more than a surgeon. His passion for helping endometriosis sufferers and determination to improve the quality of life in all of his patients is undeniable. I remember when my gynecologist first told me I needed a laparoscopy. Her exact words were "I can do the surgery, but if you were MY daughter- I'd send you to him." From the first day I met him he took the time to explain endometriosis to me since I knew…
I was there for hysterectomy but then I found out that I also had endometriosis.My both surgeries went excellent and I feel great!.I am so thankful to Dr.Seckin and all his team for making my journey smooth!
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Dr Seckin and his team gave me back my life! Tomorrow will be 1 month since my surgery and I feel great. Dr. Seckin, Dr Liu, and Dr Goldstein are not only beyond words talented and amazing Doctors, but they are also genuinely wonderful and caring people. I cannot say enough great things about Holly, Asiye and Kim as well. They were all caring, kind, patient, and took the time to listen to me and explain anything I needed to…