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Endometriosis
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Endometriosis

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Endometriosis is a condition in which the endometrium, tissue that normally lines the uterus, grows in other areas of the body, causing pain, irregular bleeding, and frequently infertility.

Treatment

Endometriosis can be treated with medications or surgery. The approach you and your doctor choose will depend on the severity of your symptoms and whether you're hoping to become pregnant.

Pain medications
Your doctor may recommend that you take an over-the-counter pain reliever, such as ibuprofen, to help ease painful menstrual cramps. However, if you find that you require the maximum dose without full relief, it may be a sign that you need to try another treatment approach to manage your symptoms.

Hormone therapy
Supplemental hormones are effective in reducing or eliminating the pain of endometriosis. That's because the rise and fall of hormones during a woman's menstrual cycle causes endometrial implants to thicken, break down and bleed. In fact, if hormonal therapy has little to no effect on your symptoms, consider questioning the diagnosis of endometriosis or its relationship to your symptoms.

Hormonal therapies used to treat endometriosis include:

  • Oral contraceptives. Birth control pills help control the hormones responsible for the buildup of endometrial tissue each month. Taking the pill long-term can reduce or eliminate the pain of endometriosis. Most women also have lighter and shorter menstrual flow when they're taking the pill. Women older than 35 who smoke shouldn't take the pill because of an increased risk of blood clots.

  • Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones. This action prevents menstruation and dramatically lowers estrogen levels, causing endometrial implants to shrink. Gn-RH agonists and antagonists can force endometriosis into remission during the time of treatment and sometimes for months or years afterward.

  • Danazol (Danocrine). This drug blocks the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. It also suppresses the growth of the endometrium. However, danazol may not be the first choice because it can cause unwanted side effects, such as acne and facial hair.

  • Medroxyprogesterone (Depo-Provera). This injectable drug is effective in halting menstruation and the growth of endometrial implants, thereby relieving symptoms of endometriosis. Its side effects can include weight gain and depressed mood.

Conservative surgery
Although hormone therapies are effective in reducing or eliminating symptoms of endometriosis, they prevent pregnancy. If you have endometriosis and are trying to become pregnant, surgery to remove implants may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery.

Conservative surgery removes endometrial growths, scar tissue and adhesions without removing your reproductive organs. Your doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases. In laparoscopic surgery, a slender viewing instrument (laparoscope) is inserted through a small incision near your bellybutton. The laparoscope is equipped with a laser, a cautery — an instrument that destroys tissue with heat — or small surgical instruments. Assisted reproductive technologies (ARTs) are sometimes preferable to conservative surgery and are often suggested if conservative surgery is ineffective.

Hysterectomy
In severe cases of endometriosis, a total hysterectomy and the removal of both ovaries may be the best treatment. Hysterectomy alone is also very effective, but removing the ovaries ensures that endometriosis will not return. Either type of surgery is typically considered a last resort, especially for women still in their reproductive years. You can't get pregnant after a hysterectomy.

Although no single treatment option is ideal for everyone, most women who seek help for endometriosis find some, if not complete, relief from their symptoms. If your pain persists or if finding a treatment that works takes some time, you can try measures at home to relieve your discomfort. Warm baths and a heating pad can help relax pelvic muscles, reducing cramping and pain.

Finding a doctor with whom you feel comfortable is crucial in managing and treating endometriosis. You may also want to get a second opinion before starting any treatment regimen to be sure you know all of your options and the possible outcomes. 

 

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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