 |
print the page |  |
email the page |  |
|
- What is endometriosis?
- Symptoms of endometriosis
- Causes of endometriosis
- Prevention of endometriosis
- Risk factors for endometriosis
- Complications of endometriosis
- When to see a doctor about endometriosis
- Diagnosis of endometriosis
- Conventional treatment of endometriosis
- Alternative/complementary treatment of endometriosis
- Living with endometriosis
- Caring for someone with endometriosis
Conventional treatment of endometriosis
Conventional treatment of endometriosis depends on a number of factors - pain levels, severity of symptoms, age and future pregnancy plans.
Medication
There are a number of medications which are prescribed (either alone or in combination) for women with endometriosis, depending on their pain levels, severity of symptoms and whether or not they plan to become pregnant:
- Androgens - this is the synthetic version of the hormone testosterone and which helps to inhibit the activity of both eostrogen and progesterone in the body and reduce effects of endometriosis. This drug has a lot of side effects (it causes masculinisation, including facial hair growth, lowering of the voice and increased cholesterol levels), which may be intolerable for many women
- GnRH agonists - gonadotropin-releasing hormone agonists are drugs which switch off the signal to the pituitary gland to produce eostrogen and progesterone which can help to reduce progression of endometriosis. GnRH agonists are usually prescribed to be taken together with the contraceptive pill, but as GnRH agonists have very serious side effects (decrease in bone density and osteoporosis) they can only be prescribed for 6 months due to these side effects (even when taken in combination with the contraceptive pill). Examples are: Goserelin, Leuprolide, Nafarelin
- Oral contraceptives - combination estradiol and progestin medications (oral contraceptives) are given to women who are of child bearing years and who are not ready to become pregnant, as they help to greatly reduce progression of endometriosis and are often prescribed after surgery to remove the endometrial implants (to prevent further growth and progression). This traditional advice is refuted by a recent study which suggests that this is not necessary as recurrence of endometrial implants after surgical removal was similar whether or not oral contraceptives were used post surgery. There are a number of different types of oral contraceptives with different ratios of estradiol and progestin
- Painkillers - there are a number of painkillers that can be either prescribed or purchased without a prescription to help reduce pain levels, depending on the amount of pain:
- Codeine-based painkillers - these are a stronger type of painkiller used for more severe pain. These painkillers can cause a number of gastrointestinal side effects
- NSAIDs - non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to reduce the level of pain and may be the only medication prescribed for women with mild to moderate pain symptoms and few endometrial implants (as diagnosed by laparoscopy). NSAIDs should be taken prior to menstruation to relieve pain symptoms. There are a number of side effects of NSAIDs, which includes stomach upset, gastritis, ulcers and should be avoided by people with asthma
- Other painkillers - there are a number of other painkillers which are stronger than the other types of painkillers and which need to be prescribed by a doctor as they are restricted in Australia (and other countries) and should not be purchased without a prescription
- Paracetemol - these painkillers can be easily purchased from any supermarket or chemist and are recommended for mild pain
- Progestins - this is the synthetic version of the hormone progesterone, which is given to reduce the effects of eostrogen in the body and reduce effects of endometriosis. The most common form of progestin is: Medroxyprogesterone acetate
Advertisement
Lifestyle modifications
Doctors also recommend the following lifestyle modifications to help reduce symptoms:
- Warm bath - a warm bath is a great way to reduce stress and relax. If your doctor thinks your stress may be contributing to an exacerbation of your symptoms, s/he may recommend you try any number of stress reducing strategies to help reduce exacerbation of symptoms
- Hot water bottle - many women feel better if they use a hot water bottle to their stomach/pelvic area during menstruation, so your doctor may also recommend this strategy for less severe pain (or together with pain relief)
- Stress reduction - while stress wont cause endometriosis, it will exacerbate symptoms and make them (and everything else) feel worse. Most doctors will suggest some stress reduction techniques to help reduce an aggravating factor
Surgery
Surgery may be required after the initial laparoscopy, as it may be inadequate to remove larger or more prevalent endometrial implants that are present on various organs and tissues, which may be hindering their proper function. Surgery is only a temporary solution to endometriosis, as the implants will grow back again in most cases, although certain medication can slow its progress and are usually prescribed at the least, straight after surgery.
Surgery can consist of:
- Hysterectomy - this is a last resort surgery, for women who either have such extensive endometrial implants that it is impossible to treat without removal of either the uterus or the ovaries or both, or for women who are past child-bearing years and want to have a permanent solution for the endometriosis. A hysterectomy will usually induce early menopause, so doctors now will not perform it so casually as it is not without risk
- Laparotomy - if more extensive surgery is required, as detected into the initial laparoscopy, a laparotomy will be performed. In this surgery, an incision (cut) is made into the abdominal wall in order for the surgeon to access the abdominal and pelvic cavities to view the regions with the extensive endometrial implants so that they can be removed. This surgery can involve
any of the following as part of the surgery:
- Electrocautery - a special device is used which produce heat by way of an electrical current and this allows the surgeon to cut out and remove the endometrial implants
- Laser ablation - the use of a laser to cut out and remove endometrial implants quickly and concisely
Advertisement
Sections: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12
< 8: diagnosis 10: alternative treatment > Last reviewed: 11 January 2010 || Last updated: 11 January 2010
Related Articles
NOTE: Mega doses of any type of vitamin, mineral, amino acid or herbal supplement cannot cure illnesses and in fact can be very dangerous and produce toxic side effects and interfere with medicine you are taking. Always ensure you consult your doctor before taking any type of complementary supplements.
Disclaimer: This guide is not intended to be used for diagnostic or prescriptive purposes. For any treatment or diagnosis of illness, please see your doctor.
