How are progestational agents administered in the treatment of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Answer

All progestational agents act by decidualization and atrophy of the endometrium.

Medroxyprogesterone acetate has proven efficacy in pain suppression in both the oral and injectable depot preparations. [71, 72] Oral doses of 10-20 mg/d can be administered continuously. The time to resumption of ovulation is longer and variable with depot preparations. Adverse effects include weight gain, fluid retention, depression, and breakthrough bleeding.

Megestrol acetate has been used in doses of 40 mg with similarly good results. [73]

The levonorgestrel intrauterine system (LNG-IUS) has been shown to reduce endometriosis-associated pain. [74] When inserted at the time of laparoscopic surgery, it has been found to reduce the recurrence of dysmenorrhea by 35%. [75]


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