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Types of hormone treatments for endometriosis

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There are several options. They all have similar success rates at easing symptoms.

The combined oral contraceptive pill ('the pill') is not strictly licensed for the treatment of endometriosis. However, many women report improved symptoms when they are on 'the pill'. The pill stops ovulation which reduces the amount of oestrogen made by the ovaries. Periods are lighter, less painful, and are predictable. Other symptoms such as painful sex, and pain in the pelvic area may also improve.
Progestogen hormone tablets reduce the effect of oestrogen on the endometrial cells which causes the cells to 'shrink'. Progestogens also prevent ovulation which lowers the oestrogen level. Progestogen hormone tablets include norethisterone, dydrogesterone and medroxyprogesterone. Side-effects that may occur include: irregular menstrual bleeding, weight gain, mood changes, and bloating.
Danazol works mainly by reducing the amount of gonadotrophins that you make. This has a 'knock-on' effect of reducing the amount of oestrogen that you make. Side-effects may occur including: weight gain, hair growth, acne, and mood changes. Rarely, it causes a deepening of the voice which may be irreversible. It usually stops periods too.
Gestrinone is similar to danazol, but you only need to take it twice a week rather than daily.
GnRH (gonadotrophin releasing hormone) analogues block the pituitary from releasing gonadotrophins. This greatly reduces the amount of oestrogen that you make in the ovaries. There are several GnRH analogue preparations which include buserelin, goserelin, nafarelin, leuprorelin, and triptorelin. Some preparations are taken as a nasal spray, some are given by injection. A six month course is usual. Side-effects may occur due to the very low levels of oestrogen that this treatment causes. For example, hot flushes, dry vagina, reduced sex drive, headaches, and difficulties with sleeping. Periods usually stop too. An option is to take a small dose of oestrogen and progestogen as hormone replacement therapy (HRT) to stop these side-effects. This 'add-back' HRT does not affect the effectiveness of the treatment.

You should use contraception with condoms if you have sex whilst taking hormone treatments (apart from 'the pill' which is a contraceptive). This is because there is a risk that hormone treatments may affect a developing baby.