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
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.
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
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:
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.
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.
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.
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.
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.
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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