Endometriosis treatment

Endometriosis is a fairly common condition in which small pieces of the endometrium, or womb lining, are actually found outside the womb. These could be in the bladder, bowel, fallopian tubes, ovaries, rectum or vagina. Endometriosis will typically cause pain in the lower abdomen, lower back or pelvis and it has even been known to lead to fertility problems. Unfortunately many women have very few or no symptoms at all and the actual cause of endometriosis is still unknown.

Endometriosis can be extremely difficult to treat, and the majority of treatments are aimed at easing the symptoms of the condition. This should allow you to go about your daily life with the minimum of interference. Treatments are intended to slow the growth of endometriosis, improve fertility, for pain relief and also to prevent the condition from returning. There are numerous factors to consider prior to deciding on the best treatment option. These will include your age, whether you wish to become pregnant, whether the major symptoms you are suffering from is pain or difficulty getting pregnant, whether you have tried any treatments for endometriosis before and also how you feel about surgery. All of these options will need to be discussed with your gynaecologist before you decide on a specific course of action.

If you are not suffering with fertility problems or if your symptoms are relatively mild, treatment may not actually be necessary. Approximately 30% of endometriosis cases will improve without the need for treatment. Many women have merely kept a close eye on their symptoms and will only choose to undergo a course of treatment if they get worse. Treatments that are available for endometriosis include:

  • Medications for pain, such as non-steroidal anti-inflammatories (NSAIDs), are typically used against the swelling and inflammation that is caused by endometriosis. NSAIDs such as ibuprofen and naproxen will also help to ease pain and discomfort and should usually be taken a few days before you expect your period pain. If you are suffering from mild pain, you can also take paracetamol, although this won’t be as effective as NSAIDs. Paracetamol is usually prescribed to replace NSAIDs if you are suffering from any side-effects such as diarrhoea, nausea and vomiting. Codeine is often used in combination with paracetamol or even alone if certain other painkillers are unsuitable. Codeine is a fairly strong painkiller, but constipation may be a side effect of taking it. This, unfortunately, can cause further problems as constipation is known to aggravate the symptoms of endometriosis.
  • Hormone treatments are often used to limit the production of oestrogen in the body. Endometriosis can feed off oestrogen and will continue to grow. Therefore, by either stopping or limiting the amount of oestrogen that this condition is exposed to, you will actually find that the endometriosis tissue can be reduced. However it is important to know that hormone treatment will have absolutely no effect on adhesions, or the sticky areas of endometriosis. Hormone treatments are basically used to stop the production of oestrogen which will eventually stop your periods. This is either achieved by putting you into an artificial state of pregnancy or an artificial state of menopause. As soon as your periods stop you will find that the endometriosis will no longer be aggravated. There are four main types of hormone-based treatment which are progestogens, anti-progestogens, the combined oral contraceptive pill and gonadotrophin releasing hormone analogues. You must also be aware that even though your periods have stopped, the majority of these treatments are not actually contraceptives.
  • Surgery is often used to improve the symptoms of endometriosis and it can also improve fertility. The procedure will remove and destroy areas of endometriosis tissue however which surgical procedure is best for you will depend on exactly where the tissue is.

The first procedure is a laparoscopy, which is a form of keyhole surgery, whereby delicate instruments are inserted into the body and the endometriosis tissue can be cut out and destroyed. Laparoscopy is most commonly used to diagnose and treat endometriosis. Additionally, heat, a laser or an electric current may be used to destroy the patches of endometriosis tissue. If ovarian cysts have formed in the meantime, these can also be removed with this procedure.

A laparotomy is used to treat severe endometriosis. This will involve making a wide cut around your bikini line, which will provide access to the affected organs and allow a surgeon to remove the endometriosis tissue. You should note that your recovery time will take far longer than a laparoscopy.

If the other two surgical procedures have not worked for you and you have decided that you do not wish to have any more children, then a hysterectomy may be the answer. This is a major operation and will have a huge impact on your body and therefore this is a major decision in your life. A hysterectomy cannot be reversed and therefore it is imperative that you discuss this with your GP or gynaecologist first. This procedure is rarely required and should only be considered as a last resort.

Last updated on Apr 4th, 2011 and filed under Genitourinary Disorders. Both comments and pings are currently closed.

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