If you have painful periods, painful sex, lower abdominal pains, or vague pelvic complaints, you may have endometriosis. Simple facts show that of women who are infertile about 50% have endometriosis, and of women with endometriosis about 50% of them will be infertile (statistics vary according to the study and exact stage of endometriosis).. Exactly why endometriosis causes infertility is unfortunately not exactly known, however consistently it has been shown that treatment of pain, and treatment of advanced endometriosis related fertility is important for cure. Current therapy such as the medication Lupron which can drastically lower estrogen levels, may be beneficial, although some studies suggest surgery is associated with more rapid times to conception than medication or medication with surgery. Endometriosis tends to be a progressive disease and 30-60% of patients will progress if not undergoing treatment, and we cannot predict which patients will progress. At Women's Health Practice we can often offer Clinical Research Trials that are on going on this topic. Then it's time to get into Women's Health Practice to evaluate your symptoms and to see if we can help you make a diagnosis and get therapy, it may be you need other treatments or evaluations for getting pregnant so time to gab with us as to what the best way to get pregnant will be.
As of July 23rd a new medication called ORILISSA, with the ability to suppress luteinizing hormone (LH) and follicle-stimulating hormone (FSH) concentrations, leading to decreased blood concentrations of estradiol and progesterone,, was approved for the treatment of endometriosis.
ORILISSA is now available in two oral dosage strengths: 150 mg tablets once a day and 200 mg tablets twice a day. The recommended duration of use is 24 months for the 150 mg QD or 6 months for the 200 mg BID starting with the lowest effective dose, taking into account the severity of symptoms and treatment objectives. It cannot be taken if you are pregnant, have osteporosis, and may cause irregular bleeding. Estrogen containing contraceptive pills may be slightly less effective when taken with ORILISSA. In addition the package insert will contain a warning regarding possible mood disorders and suicidal ideation.
Most common adverse reactions occurring in >5% in patients treated with ORILISSA in clinical
trials were hot flushes or night sweats, headache, nausea, insomnia, amenorrhea, depressed mood, depression, depressive symptoms and/or tearfulness, anxiety and arthralgia.