Lupron and endometriosis

[duff0015]

Hi there,

I don't know if you remember but I am the one that had early stage bc at a young age (BRCA neg, no family hx).  I am on Lupron and Tamoxifen for bc and have been followed for a shrinking possible endometrioma (2 cm now).  

I am very concerned about Tamoxifen and endometriosis.   SInce taking the drugs for a few months, I have had periodic pelvic cramping and pains.  No abnormal disharge or bleeding.  I am afraid that it may be making my endo worse and increase my risk for endometrial cancer (among many others...).  My gyn thinks that the two drugs MAY cancel each other out in regards to endometrial thickening.    What do you think?  I have read that Tamoxifen is contraindicated in patients with endo.  

Also, many young women are taking AI's with OS (SOFT trial, TEXT, etc).  Does Lupron fully suppress ovarian function?  Is the three month does as effective in doing so as the once a month?  My onc gives me the three month depot but I start to get more cramping around the second month so I always wonder.  My estradiol level was 11 before receiving my second shot.  

Thanks so much for your expertise!!!  Very difficult decisions and such a complex situation.   I am still debating the bilateral but that's another story!  

[Annekathryn Goodman, M.D.]

hi There,
you should ask your medical oncologist about changing from tamoxifen to arimidex. Arimidex does not bind to endometrial tissue and may be a better choice in the setting of endometriosis. lupron will cause an artificial menopause. Estrogen levels show be below 30
take care

[duff0015]

Hi Dr.  Goodman,

My labs were just checked again after six months on Lupron.  My estradiol was actually higher (21) before getting my dose.  To ensure a post-menopausal state, what should the levels be?  

Thanks.