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PITTSBURGH (KDKA) – About one in every 10 women has the same problem as Melissa Dellovade.
“Having very heavy periods, very painful periods when I was younger,” Melissa describes.
She was diagnosed with endometriosis when her appendix came out. Her surgeon found endometrial tissue in her abdominal cavity where it shouldn’t be.
Endometriosis is when the tissue lining the uterus makes its way out of the organ and sets up on the ovaries, Fallopian tubes, and on the outside of the womb. The hallmark symptom is a chronic pelvic pain.
“Some patients have very disabling pain,” says Dr. Benard Peticca, an OBGYN at Forbes Hospital.
Surgery and a biopsy can clinch the diagnosis.
The first line of treatment with medicine is birth control pills, anti-inflammatory medicines, and intrauterine devices with progesterone.
The next step is an injectable drug called Lupron, which shuts down estrogen production.
“Estrogen drives endometriosis,” says Dr. Peticca.
While the shut down helps the endometriosis, it also causes problems
“Almost an immediate onset of menopause symptoms like hot flashes, vaginal dryness, irritability, sleeplessness,” says Dr. Deborah Lenart, an OBGYN at St. Clair Hospital
Three out of four women get relief from their endometriosis symptoms with standard treatments.
“Definitely the cramps were better being on birth control,” says Melissa.
But for those who need something else, there is now a new option. It works similarly, but it’s a twice a day pill called Orilissa. The lower dose can be used up to two years…the higher dose, six-months.
Ordinarily, signals from one part of the brain tell another part, the master gland called the pituitary, to rev up the ovaries to make estrogen. This new drug blocks the signals. As a result, estrogen production shuts down.
Orilissa was recently FDA approved. In studies of nearly 2,000 women with moderate to severe pain, when compared to placebo over three to six months, the drug reduced pain with periods, non-period pain, and pain with sex.
Side effects are symptoms of menopause, similar to Lupron, but milder and more gradual.
Also noted — a decrease in bone density.
Another issue is the cost — without insurance $845 a month.
“So you’re talking about 10-thousand dollars a year. That’s costly. So you can see that’s not going to be the first line,” says Dr. Peticca.
“Typically they come out with savings programs at least for a while until they obtain some insurance coverage,” says Dr. Lenart.
Melissa eventually had surgery to treat her endometriosis, but she can see why women might go with this new pill option first.
“People don’t realize how big of a problem endometriosis is. I have friends who have debilitating pain from the endometriosis,” says Melissa. “If they had something orally, it would be much, much better than having to do an injection.”