Endometriosis Treatment - Towards A Better Reproductive Life

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.