During the last stage of the menstrual cycle, normally a layer of endometriosis lining on the inside of the uterus is expelled, known as menstruation blood, instead some of the endometriosis tissues grow somewhere in the body to cause endometriosis. Endometriosis also react to hormone signals of the monthly menstrual cycle, by building and breaking up tissues and eliminating them through menstrual period.
This type of pill contains no estrogen, also known as the progesterone-like pill or progestins, it helps to maintain milk production for breastfeeding mother and to thicken the cervical mucus, thereby preventing sperm from entering the uterus. This type of pill must be taken at a certain time every 24 hours for effectively.
I. Types of Progesterone medicines
a) Injecting medicine
Type of progesterone medication injected in the women body every three months, such as Depo Provera. It is good for women who want to have long term contraception, it may work well for some women but study shows that it causes bone loss and sometimes osteoporosis(258).
b) Implant medicine(260)
The other type of progesterone like medicine such as Implanon is implanted into the fat of a non dominant arm and last about 3 years. It may not cause bone loss as Depo Provera, but it causes male like pattern such as excessive hair growth and deepening the voice.
c) Oral Progesterone-like pills(257)(258)
i) Progesterone like pill in treating excessive menstruation
If a woman does not have progesterone irregularity, her doctor may prescribe this type of medicine for her. It helps to complete shredding of the endometrium and stops the abnormal bleeding. Besides all the good thing of this type of progesterone like pill, it also has it side effects, such as utilizing in nicotine addiction, traumatic brain injury (recently entered Phase III trial) and Alzheimer's disease, diabetic neuropathy and crush injuries(261).
ii) Other types
Other types of progesterone like medicines, such as Provera, Duphaston, they helps to relieve of menstrual cramp with no long term serious side effects by creating the pregnancy-like state but their short term side effects including spotting and bleeding, return of menses (258).
II. Side effects
Most side effects are caused by high levels of progesterone for women taking the progesterone only pill, such as
1) Anxiety and Mood swing(263)(264)
2) Weight gain(262)
3) Reduced libido(263)(264)
4) Fluid retention(265)
5) Acne(259)
6) Breast tenderness(270)
7) Oedema(259)
8) Hot flush(259)
III. Risks
1) Ectopic pregnancy
Women taking the progesterone only pill may increase the risk of pregnancy inside the fallopian tube
(259) Progesterone only pill may increase the risk of pain in the lower abdomen(261), shortly after a missed or light period.
3) It also increases the risk of developing small, benign cysts in the ovary(269).
4) Breast(266), endometrial(267)(268) cancer(269)
5) Uterine fibroids(269)
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(257) New trends of progestins treatment of endometriosis.by Angioni S1, Cofelice V, Pontis A, Tinelli R, Socolov R.(PubMed)
(258) The role of progestins in treating the pain of endometriosis.by Surrey ES.(PubMed)
(259) Progestagens and anti-progestagens for pain associated withendometriosis by Brown J1, Kives S, Akhtar M.(PubMed)
(260)Endometriosis: pathogenesis and treatment by Vercellini P1, Viganò P2, Somigliana E1, Fedele L1.(PubMed)
(261) Novel actions of progesterone: what we know today and what will be the scenario in the future?by Kaore SN1, Langade DK, Yadav VK, Sharma P, Thawani VR, Sharma R.(PubMed)
(262) Weight change at 12 months in users of three progestin-only contraceptive methods by Vickery Z1, Madden T, Zhao Q, Secura GM, Allsworth JE, Peipert JF.(PubMed)
(263) Sexual function, mood and menopause symptoms in Lithuanian postmenopausal women by Jonusiene G1, Zilaitiene B, Adomaitiene V, Aniuliene R, Bancroft J.(PubMed)
(264) Relation of androgen receptor sensitivity and mood to sexual desire in hormonal contraception users by Elaut E1, Buysse A, De Sutter P, De Cuypere G, Gerris J, Deschepper E, T'Sjoen G.(PubMed)
(265) Calculated effect of fluid retention upon velocity of blood flow and turbulence: implications for atherosclerosis by Blankfield RP.(PubMed)
(266) Progestins and progesterone in hormone replacement therapy and the risk of breast cancer by Campagnoli C1, Clavel-Chapelon F, Kaaks R, Peris C, Berrino F.(PubMed)
(267) Risk of endometrial cancer following estrogen replacement with and without progestins by Weiderpass E1, Adami HO, Baron JA, Magnusson C, Bergström R, Lindgren A, Correia N, Persson I.(PubMed)
(268) Risks of Endometrial Cancer Associated With Different Hormone Replacement Therapies in the E3N Cohort, 1992-2008 by Fournier A, Dossus L, Mesrine S, Vilier A, Boutron-Ruault MC, Clavel-Chapelon F, Chabbert-Buffet N.(PubMed)
(269) Progesterone action in endometrial cancer, endometriosis, uterine fibroids, and breast cancer by Kim JJ1, Kurita T, Bulun SE.(PubMed)
(270) Types of progestogens in combined oral contraception: effectiveness and side-effects by Lawrie TA1, Helmerhorst FM, Maitra NK, Kulier R, Bloemenkamp K, Gülmezoglu AM.(PubMed)
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