Prescribed progesterone in the effective treatment of endometriosis

In an interview for the March issue of Vogue, 31 year-old actress, Lena Dunham talks extensively about her struggle with endometriosis and how she underwent a full hysterectomy to end her pain.

Dr Jan Toledano at The London Hormone Clinic suggests that progesterone can in many women help prevent serious progression of the disease thus preventing the effects, such as infertility and pain.

“Women with endometriosis will often have low progesterone levels and other corresponding symptoms such as PMS and migraines. Treatment with progesterone can halt the progression of endometriosis by opposing the effects of oestrogen that stimulates the condition. It can even switch off the condition altogether.

“Bio identical Progesterone – available on the NHS – is safe enough to take indefinitely and has many other health benefits too. The body’s happy hormone, it helps sleep and can ease anxiety symptoms.

“Another non-surgical treatment is the contraceptive pill, which can ease the pain of the condition but does not treat the underlying problem.”

What is endometriosis?

 A complex systemic disease with a large number of triggers, endometriosis occurs when the cells that line the womb end up into the wrong place. This might be in the pelvis, near the bowel, bladder and even above the diaphragm.

The side effect of this is usually severe pain during, before, and after periods and often mid cycle as well.

By the time the correct diagnosis arrives, many women with the condition will have already suffered organ damage and their fertility has been adversely affected.

What are the symptoms? 

Typically a woman with endometriosis will suffer with terribly painful periods and may have sought medical help on many occasions. But unless the condition is picked up and treated, many continue to suffer for decades.

“Hysterectomy is the final option for women with uncontrolled endometriosis, where they have already had countless surgeries to try to alleviate the condition. The reason that the effects of surgery do not last and need to be repeated, is because of an underlying hormonal imbalance that has not been addressed. Even post-hysterectomy, Oestrogen (given as HRT after surgery) can cause the endometriosis to be active.

“After a hysterectomy the condition can recur when women are given oestrogen – as they will be if they have a hysterectomy at a young age – to prevent bone and heart disease.

‘Therefore, when hysterectomy becomes the only option, it is still important for progesterone to be prescribed, to ensure oestrogen levels do not trigger the disease all over again.”

What causes endometriosis?

“There is likely a genetic predisposition to extra sticky cells of the womb lining. Retrograde menstruation – when blood does not always flow in the right direction during a menstrual bleed – can also be a trigger.

“Endometriosis is also much more common than it used to be. The reason for this is likely due to environmental chemicals called xenoestrogens, which mimic the action of oestrogen in the body. These are commonly found in many of today’s makeup and plastics.”

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