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What is the best treatment option for endometriosis? |
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What about a natural remedy or diet? |
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What is the best treatment option for endometriosis?
There are 2 choices for managing endometriosis, medical or surgical.
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Medical management
- Suppression of cyclic ovarian function will reduce endometriosis pain related symptoms.
Estrogen/progestin contraceptives(EPCs) are generally the first recommendation, especially for younger women. EPCs reduce menstrual cramps, flow, and intercourse related pain in about 50% of cases. Side effects, complications, failure to control or return of symptoms cause the other 50% to seek further consultation. of It is possible to give E/P's continuously to extend the interval between periods, thus decreasing periods to 6 or less each year. It doesn't work for every woman but is worth a try.
GNRHa ( gonadotropin releasing hormone agonist) are a class of compounds that selectively stop the pituitary gland from stimulating the ovaries.
Drugs that suppress the activity of the ovaries can slow the growth of the endometrial tissue implants. There are a variety of medicines, each with their own side effects, so you and your doctor should discuss the options. This can keep the symptoms under control. It should be kept in mind that drug treatment does not cure endometriosis, it will probably return if the treatment is stopped.
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There are side effects that can increase the risk of osteoporosis or heart
disease. Consultation with your physician is necessary.
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Bladder symptoms sometimes indicate endometriosis of the anterior pelvis. This
cannot be addressed by THL, but only occurs in 4% of the cases. Patients with
bladder symptoms may be better candidates for micro-laparoscopy.
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Operative THL is also ideal for thin, filmy adhesions of the pelvis, which interfere
with tuboovarian function. This is very important to the woman trying to
conceive.
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Laparoscopy - This requires small incisions in the abdomen so a scope
can be inserted through the belly button to diagnose or treat
endometriosis. If endometriosis is identified at the time of diagnostic laparoscopy,
an operative laparoscopy can then be performed to remove the endometrial tissue implants.
This requires additional small incisions for the placement of graspers, scissors, and
other instruments to remove the implants. The procedure is done as an outpatient and
return to work is expected in approximately 2 weeks or less.
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There are various laparoscopes. Originally, these scopes were 10-mm in size. Advances in
fiberoptic technology allow us to now use 3 and 5-mm scopes. It is important to discuss
the size of the scope and the accessory ports with the doctor because the size of the
incision will contribute to recovery. The Advanced Women's Health Institute uses either a
3 0r 5-mm scope because we feel that 10-mm scopes are no longer necessary.
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Open Abdominal Surgery for Endometriosis - This procedure is accomplished using a 4-6 inch open abdominal incision to
perform the operation. However, laparoscopy represents a less invasive, less
painful approach to endometriosis. As of June 16, 2002, Advanced Women's
Health Institute's database shows that we have treated 311 patients with
endometriosis and 0 have had an open abdominal procedure.
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American Fertility Society Endometriosis Staging
Patients treated by Advanced Women's Health Institute for:
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Stage I |
174 |
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Stage II |
84 |
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Stage III |
33 |
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Stage IV |
20 |
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What about a natural remedy or diet?
It may be possible to manage some
symptoms with various alternative methods.Advanced Women's Health Institute
is unaware of controlled studies.
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If you choose to use some alternative methods, it should be noted that all
therapies and diets should be discussed with your physician to make sure
that there is no contraindication with any prescriptions or other therapies
or treatments being performed or contemplated. Always keep an open
communication between all you practitioners.
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