Is Lupron Effective in Treating Endometriosis and Other Endo-Related Infertility?

Endometriosis has become a common gynecological condition today. It is a condition in which tissue very similar to that typically found lining the inside of the uterus can be found growing outside of the uterus. This tissue growing outside the uterus acts as it typically would in the uterus and starts thickening, getting released, and bleeding whenever you have your menstrual cycle. This leads to inflammation and pain and can cause complications such as scarring, irritation, ovarian cysts, and infertility. Lupron Depot is a commonly prescribed medication that gets injected into the body every month or once every three months to help reduce the pain and complications from endometriosis. Lupron Depot was initially developed as a treatment for advanced prostate cancer, but over time, it has become a very common treatment for endometriosis.

Read on to find out if Lupron is effective in treating endometriosis and other endo-related infertility.

Does Lupron Work for Endometriosis?

Endometriosis is a common gynecological disorder in which endometrial-like tissues start to grow on your ovaries, tissues lining the pelvis, and bowel. The lining of the uterus is known as the endometrium, and in women with endometriosis, it is this endometrial tissue that starts to grow outside of the uterine cavity.(1, 2, 3, 4)

Lupron is an effective prescription medication for endometriosis. The drug works by lowering the overall levels of estrogen in the body, as estrogen is the main factor that causes the tissues inside the uterus to start growing.(5, 6) When you first start treatment with Lupron, your estrogen levels can increase for one or two weeks. During this time, some women may even experience a worsening of their symptoms. However, after a few weeks, your estrogen levels will start to go down. This will stop the process of ovulation and also your periods. At this point, you will start experiencing relief from the pain and symptoms associated with endometriosis.(7, 8)

How Effective is Lupron for Endometriosis?

Lupron is being used to treat endometriosis since 1990. It has been found to be effective in reducing pain in the abdomen and pelvis caused by endometriosis. Doctors found that women with endometriosis who were taking Lupron had decreasing signs and symptoms after monthly treatment when taking the medication for six months.(9) Additionally, Lupron has also been found to reduce pain during sexual intercourse when taken for at least six months.

According to studies, the efficacy of Lupron is similar to that of Danazol, which is a testosterone medication that also works on reducing the levels of estrogen in the body to reduce endometrial pain and symptoms.(10)

However, Danazol is rarely used today ever since it was found that the medication caused many unpleasant side effects, including increased growth of body hair, weight gain and acne.(11)

Lupron as a medication is considered to be a gonadotropin-releasing hormone (Gn-RH) agonist since it blocks the production of estrogen in the body in order to decrease the symptoms of endometriosis.(12)

Can You Get Pregnant While Taking Lupron?

Lupron works by stopping your period, but it is not a method of birth control. If you are not using protection during sexual intercourse, you may still get pregnant while taking Lupron. However, to avoid any potential drug interactions and pregnancy, it is recommended that you continue to use non-hormonal methods of birth control which include a copper intrauterine device (IUD), a diaphragm, or condoms.(13)

Lupron is also commonly used during fertility treatments, including in vitro fertilization (IVF). Your doctor may prescribe Lupron to you for preventing ovulation before harvesting the eggs from your body for the fertilization process. Lupron can also be used in some cases to increase the efficiency of other fertility drugs. Typically, you take Lupron for a couple of days before you start taking injectable fertility medications.

Even though there are very limited efficacy studies, there is some amount of older research that suggests that taking Lupron may dramatically improve the rate of fertilization if the medication is used during fertility treatments like IVF.(14)

Are There Any Side Effects Of Taking Lupron?

Any medication you take has some potential side effects and risks, especially if that drug causes changes in the body’s hormones. When used alone, Lupron may cause the following side effects:(15)

Many women taking Lupron may also develop symptoms that are similar to menopause, like bone changes, decreased libido, or hot flashes. However, these symptoms tend to go away once you discontinue the use of Lupron.

How is Lupron Prescribed For Endometriosis?

Lupron is usually taken by injection once a month in a 3.75-milligram dosage. If it is taken once in every three months, the dosage increases to 11.25 milligrams. To reduce the risk of any side effects from Lupron, your doctor may also prescribe progestin add-back therapy. This is a pill that you need to take every day to help manage and reduce some of the side effects of Lupron, but without impacting the efficacy of Lupron.(16, 17, 18)

However, not everyone who is on Lupron should undertake the add-back therapy. The progestin add-back therapy is not for those who have:

Conclusion

Lupron can definitely help provide great relief from the symptoms of endometriosis in many women. However, everyone is different, and every medication reacts in different ways in different people. Before starting Lupron, make sure to let your doctor know about any existing medical condition you might be having apart from endometriosis.

Also, inform them about any medications, vitamins, or supplements you are on. Once you start the medicine, be sure to notify your doctor if you experience severe pain or if your regular periods continue even while you are on Lupron. It is possible to experience some breakthrough bleeding if you end up missing your medicine doses or you are late in taking your next dose. Also, remember that Lupron does not protect you from pregnancy, so continue to use protection while having intercourse.

References:

  1. Giudice, L.C., 2010. Endometriosis. New England Journal of Medicine, 362(25), pp.2389-2398.
  2. Lebovic, D.I., Mueller, M.D. and Taylor, R.N., 2001. Immunobiology of endometriosis. Fertility and sterility, 75(1), pp.1-10.
  3. Eskenazi, B. and Warner, M.L., 1997. Epidemiology of endometriosis. Obstetrics and gynecology clinics of North America, 24(2), pp.235-258.
  4. Farquhar, C.M., 2000. Endometriosis. Bmj, 320(7247), pp.1449-1452.
  5. Dlugi, A.M., Miller, J.D., Knittle, J. and Lupron Study Group, 1990. Lupron depot (leuprolide acetate for depot suspension) in the treatment of endometriosis: a randomized, placebo-controlled, double-blind study. Fertility and sterility, 54(3), pp.419-427.
  6. Wright, S., Valdes, C.T., Dunn, R.C. and Franklin, R.R., 1995. Short-term Lupron or danazol therapy for pelvic endometriosis. Fertility and sterility, 63(3), pp.504-507.
  7. Scribner Jr, D.R. and Walker, J.L., 1998. Low-grade endometrial stromal sarcoma preoperative treatment with Depo-Lupron and Megace. Gynecologic oncology, 71(3), pp.458-460.
  8. Hornstein, M.D., Surrey, E.S., Weisberg, G.W., Casino, L.A. and Lupron Add-Back Study Group, 1998. Leuprolide acetate depot and hormonal add-back in endometriosis: a 12-month study. Obstetrics & Gynecology, 91(1), pp.16-24.
  9. Accessdata.fda.gov. 2021. [online] Available at: <https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020011s040lbl.pdf> [Accessed 21 November 2021].
  10. Cottreau, C.M., Ness, R.B., Modugno, F., Allen, G.O. and Goodman, M.T., 2003. Endometriosis and its treatment with danazol or lupron in relation to ovarian cancer. Clinical Cancer Research, 9(14), pp.5142-5144.
  11. Nagata, Y., Nakamura, G. and Kusuda, M., 1982. Therapeutic effect and side effects of danazol in endometriosis. Asia‐Oceania Journal of Obstetrics and Gynaecology, 8(3), pp.229-236.
  12. Pelican, K.M., Wildt, D.E. and Howard, J.G., 2006. GnRH agonist Lupron®(leuprolide acetate) pre-treatments prevent ovulation in response to gonadotropin stimulation in the clouded leopard (Neofelis nebulosa). Theriogenology, 66(6-7), pp.1768-1777.
  13. Raab, D. and Levine-Goldberg, A., 1998. Getting Pregnant and Staying Pregnant: Overcoming Infertility and Managing Your High-risk Pregnancy. Hunter House.
  14. Chetkowski, R.J., Kruse, L.R. and Nass, T.E., 1989. Improved pregnancy outcome with the addition of leuprolide acetate to gonadotropins for in vitro fertilization. Fertility and Sterility, 52(2), pp.250-255.
  15. Gallagher, J.S., Missmer, S.A., Hornstein, M.D., Laufer, M.R., Gordon, C.M. and DiVasta, A.D., 2018. Long-term effects of gonadotropin-releasing hormone agonists and add-back in adolescent endometriosis. Journal of pediatric and adolescent gynecology, 31(4), pp.376-381.
  16. Friedman, A.J., Daly, M., Juneau-Norcross, M., Gleason, R., Rein, M.S. and Leboff, M., 1994. Endocrinology: Long-term medical therapy for leiomyomata uteri: a prospective, randomized study of leuprolide acetate depot plus either oestrogen—progestin or progestin ‘add-back’for 2 years. Human reproduction, 9(9), pp.1618-1625.
  17. Mezrow, G., Shoupe, D., Spicer, D., Lobo, R., Leung, B. and Pike, M., 1994. Depot leuprolide acetate with estrogen and progestin add-back for long-term treatment of premenstrual syndrome. Fertility and sterility, 62(5), pp.932-937.
  18. Friedman, A.J. and Hornstein, M.D., 1993. Gonadotropin-releasing hormone agonist plus estrogen-progestin “add-back” therapy for endometriosis-related pelvic pain. Fertility and sterility, 60(2), pp.236-241.