When deciding on a course of endometriosis treatment a number of factors need to be taken into consideration.
The recommended course of treatment among other things depends on the severity of symptoms, family history and whether the patient is actively trying for a baby.
Understanding the patents situation and aspirations helps determine treatment plans that can effectively deals with all aspects of the condition.
Common patient goals include relief of dysmenorrhea, the pain associated with endometriosis, which is usually severe enough to limit normal day to day activities, relieving dyspareunia (pain during intercourse), and being able to fall pregnant.
As the treatment progresses, some women find that due to their endometriosis pregnancy may be hard to achieve and in some cases not possible.
The impact of knowledge must be recognized and addressed, and alternatives, such as in-vitro fertilization or adoption, may be discussed at the appropriate time and referrals to the appropriate clinics or advisors offered.
One of the main roles of health care providers administering Endometiosis treatment is to dispel myths and encourage the patient to seek care if dysmenorrhea or dyspareunia occurs.
Treatment Options
Treatment depends on the symptoms, the patient’s desire for pregnancy, and the extent of the disease. Therapy for varying degrees of symptoms may be NSAIDs, oral contraceptives, GnRH agonists, or surgery. Should pregnancy occur, it can often alleviate symptoms because neither ovulation nor menstruation occurs during this time.
However, it is worth noting that endometriosis symptoms often return after the pregnancy and can be just as bad or worse.
Palliative measures include use of medications, such as analgesic agents and prostaglandin inhibitors, for pain.
Hormonal therapy is effective in suppressing endometriosis and relieving dysmenorrhea (menstrual pain). Oral contraceptives are used frequently. Side effects that may occur with oral contraceptives include fluid retention, weight gain, or nausea. These can usually be managed by changing brands or formulations. Injectable contraceptives agents may also be used.
Several types of hormonal therapy are also available in addition to the oral contraceptives.
A synthetic androgen, danazol (Danocrine), can cause atrophy of the endometrium and subsequent amenorrhea (menstruation stops). The medication inhibits the release of gonadotropin with minimal overt sex hormone stimulation. The drawbacks of this medication are that it’s expensive; and may cause side effects such as fatigue, weight gain, mild acne, depression, oily skin, hot flashes, decreased breast size, and vaginal atrophy (dryness).
Surgical Options
If the treatment methods outlined above are not helpful, surgery may be necessary to relieve pain and enhance the possibility of pregnancy. Surgery may be combined with use of medical therapy. The procedure selected depends on the patient.
Laparoscopy may be used to remove endometrial implants and release adhesions.
Laser surgery is another option made possible by laparoscopy. Laser surgery vaporizes or coagulates the endometrial implants, thereby destroying this tissue.
For women older than 35 or those willing to sacrifice reproductive capability, a total hysterectomy is an option, although less likely to be recommended than previously. As Endometriosis can occur outside of the reproductive organs it recurs in many women after a hysterectomy unless all the endometrial implants have been removed.
Generally, surgical management is used when the extreme pain caused by endometriosis becomes debilitating. Or when a patient is trying to become pregnant. Surgical treatments tend to be more successful than medical ones when it comes to fertility issues.
Indeed, there are many forms of treatment, some of which we haven’t had the chance to touch on in this article. If you would like more information about choosing the best endometriosis treatments for you then sign up to the free newsletter below.
Watch video related to endometriosis treatment
Dr. Sherman Silber brought the Osada procedure to the United States. This unique procedure used to treat massive endometriosis was developed by the Japanese infertility doctor Yoshihito Osada. Dr. Silber explains and demonstrates the Osada procedure and discusses the use of this procedure as an alternative to a hysterectomy in the treatment of endometriosis.
Help answer the question about endometriosis treatment
What are options for treatment of endometriosis other than birth control or surgery?I have already been on birth control for 9 years, and I can't afford a laparoscopy because I have crappy insurance. Are there any other treatment methods for endometriosis?
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Lupron Depot (leuprolide acetate for depot suspension) is a GnRH agonist — a hormone that works in two distinct phases. Phase one stimulates the ovaries causing them to produce more of the most potent of the three estrogens produced by women — estradiol. In phase two the messenger hormones that tell the ovaries to produce estrogen decline dramatically. This causes a significant reduction in estrogen levels, and causes women to experience menopause-like side effects.
Lupron is prescribed for women with very bad endometriosis, severe menorrhagia, and before assisted reproduction. In men, Lupron is used to treat advanced prostate cancer, and the drug is used in children who are diagnosed with central precocious puberty (early puberty). Before you decide to use Lupron, make sure you understand the facts about the benefits and side effects so that you can make an informed decision.
Side Effects and Lupron Depot
Side effects that have been associated with the use of Lupron Depot frequently include hot flashes and night sweats, and less frequently palpitations, syncope, and tachycardias. Other side effects include generalized pain, headaches, vaginitis, nausea/vomiting, fluid retention[, weight gain, acne, hirsutism, joint pain, loss of sexual desire, depression, dizziness, nervousness, and breast changes such as tenderness and pain. There have been no deaths directly related to therapy with Lupron Depot.
Lupron is an effective and medically accepted treatment for endometriosis. Despite the fact that many women do experience side effects during treatment with Lupron Depot, women often consider these side effects to be a necessary price to pay for the relief of the severe pain and suffering of endometriosis.
This is an option I am considering for myself, and most insurances are covering it since it's non-invasive and non-surgical.
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