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Non-steroidal anti- inflammatory agents
With attention to inflammatory nature of endometriosis, for decades non- steroidal anti-inflammatory agents (NSAIDs) such as naproxen and ibuprofen have been administrated for pain control, in endometriosis. These drugs have been reduced prostaglandins (PGs) production, the main stimulator factor in peritoneal nerves and decrease the nociceptor input messenger from the peritoneal endometriotic implants into central nervous system.
1.Continuous oral contraceptive pills – suppress LH and FSH and prevent ovulation
2.Medroxyprogesterone injections (Depo-Provera) – similar to OCP
3.Danazol – a weak androgen that can be used for a short time period only due to the possibility of osteoporosis development, has numerous side effects such as weight gain, fluid retention, acne, hirsutism, and voice deepening. It inhibits LH and FSH from being released leading to low estrogen and endometrial atrophy
4.GnRH agonist (leuprolide, gosarelin) that will negatively feedback to reduce the GnRH secreted also leading to low estrogen, side effects include hot flashes, vaginal dryness, and reduced libido