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Oral Contraceptives (OCPs)
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- Usually tried as initial therapy
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- Limited success due to the progesterone component of OCPs
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- Fewer side effects than other most other therapies
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Antihistamines
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- Well tolerated, few side effects
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- Rarely effective as monotherapy
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| | |
- Does not address underlying mechanism
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Conjugated Estrogens
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- Avoids progesterone component of OCPs
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- Increased risk of endometrial cancer, not commonly used today
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| | |
- Often require high doses
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Glucocorticoids
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- Able to suppress multiple components of the immune system
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- Usually not effective alone
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- Can be combined with other therapies
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- Often require high doses
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GnRH Agonists
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- Often used if OCPs and glucocorticoids are not effective
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- Can cause symptoms of estrogen deficiency (hot flashes, decreased bone mineral density)
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Alkaylated Steroids
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- Can be combined with low dose steroids
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- Can cause symptoms of excess androgens (facial hair, hepatic dysfunction, mood disorders)
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- Interferes with gonadal hormone receptors
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Tamoxifen
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- Has been used successfully in patients unresponsive to conjugated estrogen
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- Can cause symptoms of estrogen deficiency
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| | |
- Increased risk of venous thrombosis and cataract formation
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Bilateral oopherectomy
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- Definitive treatment, used if medical options unsuccessful
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- Surgical procedure, associated morbidity
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| | |
- Symptoms of estrogen deficiency
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