Progestin for Endometriosis
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.
How It Works
Progestin 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 (endometrium) and endometriosis implants elsewhere in the body. Progestin also reduces estrogen production, which stops ovulation and menstrual periods in most women.
The 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.
Why It Is Used
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 pregnancy.
How Well It Works
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 therapy.1
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:
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.)
What To Think About
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.
Advice for women
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.
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