A team of Italian gynecologists in Milan treated 50 women with endometriosis by having them take oral contraceptives continuously without the usual 1-week pause. This ensured that there were no menstrual periods during which pain could occur. After 2 years, 80 percent of the women reported that they were satisfied with the treatment and that it had resulted in less pain. According to the president-elect of the American Society of Reproductive Medicine, "if women suffering from endometriosis are not ready to become pregnant, continuous oral contraceptive use is one of the better ways to manage pain. The effect of the Pill is reversible, so future fertility is possible, and if side effects (of the Pill) are more troublesome than warranted by pain relief, it can be easily discontinued. For these reasons, oral contraceptives are an excellent option" for the management of the symptoms of endometriosis.
There is no downside to taking the Pill continuously to suppress menstruation. The FDA has just approved Seasonale (ethinyl estradiol/levenorgestrel), a contraceptive pill that allows women to have just four menstrual periods a year.
Another promising approach to reducing the pain of endometriosis is one of the aromatase inhibitors used in the treatment of advanced breast cancer. In a small study done at Northwestern University Feinberg School of Medicine in Chicago, researchers found that 10 premenopausal women with painful endometriosis who had previously not responded to any other therapy experienced dramatic improvement in their symptoms after taking an aromatase inhibitor. In this case, the drug used was Femara (letrozole), one of several in this class. There were no significant side effects or complications during a 6-month period.
If you are troubled by ongoing pain, bleeding, and cramps from endometriosis, and you cannot be treated surgically, you should consider going on the Pill and taking it nonstop -- that is, without the customary week off once a month. When you want to begin trying to have a baby, you simply stop the Pill.
Another alternative for controlling the pain of endometriosis that's worth exploring with your doctor is an aromatase inhibitor called Femara. Results of a small study of premenopausal women with pain not responsive to other medication suggest that it's worth a try. Side effects and complications from its use appear to be minimal.
Dr. Isadore Rosenfeld is the best-selling author of nine books, including Live Now, Age Later and Dr. Rosenfeld's Guide to Alternative Medicine. He is a distinguished member of the faculty at New York-Presbyterian Hospital/Weill Medical College of Cornell University and attending physician at New York-Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center. Dr. Rosenfeld can be seen every Sunday morning on his popular show Sunday Housecall on Fox News Channel. He is the health editor and a regular columnist for Parade magazine.
Copyright © Dr. Isadore Rosenfeld. Permission to republish granted to Pregnancy.org, LLC.