While many patients may find relief from some of their most debilitating symptoms with these pharmaceuticals — there isn't much to suggest that these drugs treat endometriosis. They treat the symptoms. I spoke with Dr. Siedhoff a bit more in depth about these drugs. But before we get into it, I just want to be clear: If you were prescribed these drugs because you don't have the means to get an excision surgery and they are giving you relief, you deserve that relief. Full stop.
Lupron has historically been one of the most commonly prescribed medications for endometriosis patients, and it essentially puts your body into a chemical menopause. According to Dr. Siedhoff, he "almost never uses these medicines" in his practice. He went on to tell BuzzFeed, "Some women feel all of the symptoms of menopause with Lupron — things like hair loss and hot flashes and joint pains and insomnia, vaginal dryness, pain with intercourse. And some of that can be helped by giving back more hormones in the form of a progesterone or a birth control pill, which can also help protect bones, because putting somebody into medical menopause causes bone loss. Which is also a reason why these drugs can’t be used long-term. So although someone may experience relief in some of their symptoms, It’s at a big trade-off with all those other symptoms. And when you compare treatments with a better side effect profile — for example, a progesterone IUD or oral progesterone or just standard birth control pills — they don’t really perform better than those hormonal treatments that have fewer side effects."
And Dr. Siedhoff feels the same way about the newest medication, Orilissa (Elagolix). "It’s basically inducing menopause in a similar way that Lupron does. It’s just a oral medicine rather than an injection. So, you could stop it a little bit easier, and it’s a bit easier to take for the patient. Right now, we have the data that justified getting it approved by the FDA, which shows that it can improve pain associated with periods and pelvic pain in general. But we don’t have great comparative data with other medicines that have fewer side effects. So, with all of that being said, I’m sure there are some people that feel better on it and are doing well, but I don’t think it’s very often. And I really don’t use them. And like I said, you can’t use them for long-term because of the dangers with with bone density and bone loss."