The Mirena IUD, The Arimidex and The Norethindrone: The Trifecta of Medications

It's been awhile since I've had a chance to give a blog post update for myself. It has now been a month since I had the Mirena IUD reinserted and have started back on the Arimidex and Norethindrone. I've also been taking my Cesamet (Nabilone) and Lyrica to help manage the pain. I haven't noticed that much of a difference as yet in my endometriosis symptoms, but then again, it has only been a month since starting treatment and I know that realistically it could take several months to see any differences, if they are to happen at all. I continue to bleed heavily at times, I have pain that brings me to my knees and has me in tears at times. The pain medications have helped to greatly reduce the severity of my pain. I am able to function, and for that I am grateful, especially with two small children.

I've decided to use this blog post to write a bit on my trifecta of treatments: The Mirena IUD, the Arimidex and the Norethindrone.

For those who have read my story so far, I've been on multiple treatments for endo since being diagnosed at 23. I've done countless birth control pills, a single shot of Depo-Provera, had two courses of Danazol treatment, and have decided against Lupron use. My options were pretty limited when my doctor suggested the Mirena IUD. I had the Mirena for a year when my symptoms started acting up again, namely heavy bleeding, pain and visible bleeding in my torso muscles. After doing much research, I brought the research on Arimidex (aromatase inhibitors) to my doctor who agreed to let me take the Arimidex. He also prescribed Norethindrone as a way of warding off some of the bad effects aromatase inhibitors can have on bone density. This treatment did help to manage my symptoms for me in the past, so it was an easy decision for me to restart this treatment program again now.

The Mirena IUD is a tiny plastic t-shaped intra-uterine device that releases a progesterone (levonogestrel) directly to the uterus. For a full description of the side effects see:http://www.rxlist.com/mirena-drug.htm. The Mirena is inserted at the OBGYN's office. It is only supposed to have minimal pain associated with having it inserted, however each person is different and several women, including myself, have found it painful. The Mirena has been shown in a few small studies to have a positive effect on helping relieve the pain symptoms associated with endometriosis. It is often only recommended for women who have had children as the uterus is already slightly enlarged afterwards, but it is also being used for women who have not bore children. It is supposed to remain effective for up to 5 years.

Arimidex is a medication that is often used to treat breast cancer. In about 2004, news broke that aromatase inhibitors had been found in a small study to help effectively treat the symptoms of endometriosis when other conventional treatments have failed. It is thought that some endometriosis cells might contain the enzyme aromatase which can fuel the production of estrogen, a very bad thing for women with endometriosis. You can read about the side effects of Arimidex here: http://www.rxlist.com/arimidex-drug.htm. The most noted side effect is the potential for bone density loss. The studies that have been completed on aromatase inhibitors have used norethindrone and Calcium and Vitamin D to offset this potential. More recent research has called into question the use of aromatase inhibitors, as a study has found that a handful of endometriosis types do not have aromatase enzymes in them. Do aromatase inhibitors hold promise for endo treatment? Further research is needed to answer this question. I find the initial studies interesting, and hold hope that my treatment with Arimidex helps.

Norethindrone is a progestagen, a form of progesterone. The hormone alone is often prescribed to help off-set the side effects of hormone-depleting drugs, or it might also be prescribed as a progesterone only birth control pill. Norethindrone might be used as a stand-alone treatment for the symptoms of endo as described here, although it is commonly used as an add-back therapy.

That is the Trifecta of my current endo treatment. I'll be sure to post more about the experience as I go through this part of the battle.

Would you ever try a medication that hasn't been proven to treat your condition? Under what circumstances would you consider it?