Endometriosis Order Sets

Below are a list of commonly used treatments in endometriosis. Always consider general analgesias, antiinflammatories, and stool softeners as well all all treatment contraindications before initating any new treatment.

Nonhormonal

  • NSAIDS

    Naproxen 500 mg PO BID PRN

    Vimovo 1 tablet (500mg/20mg) PO BID PRN (Contains Naproxen with Esomeprazole)

  • Pelvic Floor Physiotherapy

    Always consider pelvic floor physio in patients with chronic pelvic floor.

Progesterones

  • Oral Progesterones

    Dienogest (Visanne) 2 mg PO daily (continuous)

    Medroxyprogesterone acetate (Provera) 30 mg PO daily (continuous)

  • Intrauterine Progesterones

    Mirena IUD 52 mg package, inserted by MD

Ovarian Suppression Via GnRH

  • Patients treated via ovarian suppression with Lupron or other similarly acting medications should be given add back therapy.

  • GnRH Agonists

    Leuprolide (Leupron) 3.75 mg IM q monthly

    Leuprolide (Leupron) 11.25 mg IM q3months

  • Add Back Therapy

    Norethistrerone (Norlutate) 5 mg PO daily (may titrate between 2.5 mg, 5.0 mg, and 10.0 mg)

  • GnRH Antagonists

    Elagolix (Orilissa) 150 mg PO daily (for partial suppression)

    Elagolix (Orilissa) 250 mg PO BID (for full suppression - not yet available in Canada)

Surgically Induced Menopause Treatment Options

  • Estrogen Replacement Options

    Estradiol (Estradot) 50 mcg Patch Apply new patch twice weekly

    Estradiol (Estrogel) 1.25 g/day (1 pump) Apply topically to arm daily

    Estradiol (Estrace) 1 mg PO daily (may titrate between 1 - 2 mg daily)

  • Progesterone Replacement Options

    Prometrium 100 mg PO daily