Hormone treatments for endometriosis
Understanding oestrogen and how hormone treatments work
Oestrogen is a hormone that is made in the ovaries. The cells that line the inside of the uterus (endometrial cells) need oestrogen to grow and survive. The endometrial cells outside the uterus that cause endometriosis also need oestrogen. Hormone treatment works by reducing the amount of oestrogen that you make, or by blocking the effect of oestrogen on the endometrial cells. The endometrial cells are then starved of oestrogen which they need to survive. Therefore, patches of endometriosis gradually shrink, and may clear away.
It may help to understand how oestrogen is made. Hormones called gonadotrophins are made in the pituitary gland, which is a gland next to the brain. Gonadotrophin hormones are released into the bloodstream and stimulate the ovaries to make oestrogen which is also released into the bloodstream. The stimulus to release gonadotrophins into the bloodstream comes from a hormone called gonadotrophin releasing hormone (or GnRH for short). This is made in the brain and travels to the pituitary. So, in effect there is a cascade:
GnRH (brain) >> Gonadotrophins (pituitary) >> Oestrogen (ovaries) >>Endometrial cells.
The different hormone treatments work by affecting different parts of this cascade. However, the end result of all of them is to reduce the amount of oestrogen that is made, or to block the action of oestrogen on endometrial cells.
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