TREATMENT

Treatment for endometriosis has varied over the years but no sure cure has yet been found. Hysterectomy and removal of the ovaries has been considered a "definitive" cure, but Association research has found such a high rate of continuation/recurrence that women need to be aware of steps they can take to protect themselves. (Space does not allow us to detail these steps here - please see additional Association literature.) Painkillers are usually prescribed for the pain of endometriosis. Treatment with hormones aims to stop ovulation for as long as possible and can sometimes force endometriosis into remission during the time of treatment and sometimes for months or years afterwards. Hormonal treatments include estrogen and progesterone, progesterone alone, a testosterone derivative (danazol), and a new drug, GnRH, gonadotropin releasing hormone. Side effects are a problem for some women with all hormonal treatments.

Because pregnancy often causes a temporary remission of symptoms and because it is believed that infertility is more likely the longer the disease is present, women with endometriosis are often advised not to postpone pregnancy. However, there are numerous problems with the "Prescription" of pregnancy to treat endometriosis. The woman might not yet have made a decision about childbearing, certainly one of the most important decisions in life. she might not have critical elements in place to allow for childbearing and child bearing (partner, financial means, etc.). she may already be infertile.

Other factors may also make the pregnancy decision and experience harder. Women with endometriosis have higher rates of ectopic pregnancy and miscarriage and one study has found they have more difficult pregnancies and labors. Research also shows there are family links in endometriosis, increasing the risk of endometriosis and related health problems in the children of women with the disease.

Conservative surgery, either major or through the laparoscope, involving removal or destruction of the growths, is also done and can relieve symptoms and allow pregnancy to occur in some cases. As with other treatments, however, recurrences are common. Surgery through the laparoscope (called operative laparoscopy) is rapidly replacing major abdominal surgery in the U.S. and will probably also do so in other countries. In operative laparoscopy, surgery is carried out through the Iaparoscope using laser, cautery, or small surgical instruments. Radical surgery, involving hysterectomy and removal of all growths and the ovaries (to prevent further hormonal stimulation) becomes necessary in cases of long-standing, troublesome endometriosis.

Menopause also generally ends the activity of mild or moderate endometriosis. Even after radical surgery or menopause, however, a severe case of endometriosis can be reactivated by estrogen replacement therapy or continued hormone production after menopause. Some authorities suggest no replacement hormone be given for a short period (3-9 months) after hysterectomy and removal of the ovaries for endometriosis.

[Homepage] [What is Endometrioses] [Diagnoses]

The contents of this Web site are for informational purposes only and are not intended to be used for medical advice. You should consult your physician or health care provider on a regular basis. You should consult your physician immediately with any problem about which you are concerned.