Womens Health

Getting Help for Endometriosis

Pain Management

Help is available for sufferers of endometriosis but the approach used depends upon many factors, including the severity of the symptoms and whether or not you hope to conceive.

The first step in treating endometriosis involves pain management. Your doctor may suggest you try over-the-counter pain relievers such as Advil or Motrin. These may help soothe your agonizing menstrual cramps. If they don't seem to do the trick, your doctor may turn to other treatment options.

The Root Cause

Treating endometriosis with supplemental hormones is treating the root cause, since it is the rise and fall of a woman's hormones that can cause endometrial tissue to thicken in texture, break up, and bleed. Hormone therapy is so effective in treating endometriosis that should it fail, your doctor will want to reexamine his original diagnosis-you may not have endometriosis.

Hormone therapies include:

Oral contraceptives--The pill can be used to control hormones that cause the buildup of endometrial tissue and is so effective that it can reduce or even eliminate the pain associated with endometriosis.

Gonadotropin--releasing hormone (Gn-RH) agonists and antagonists-These drugs act as a block against the hormones that stimulate the ovaries. No menstruation and lowered estrogen levels leads to the shrinkage of endometrial tissue. Side effects associated with these drugs include vaginal dryness and other symptoms of artificially induced menopause, but such symptoms are well managed when a low dose of estrogen is taken alongside the treatment.

Danazol (Danocrine)--Danazol acts in much the same way as Gn-RH but is not the drug of first choice since it can bring on some nasty side effects, including acne and facial hair.

Medroxyprogesterone (Depo-Provera)--An injectable drug, Depo-Provera halts menstruation in its tracks, and with it, the endometrial implants that cause all the trouble. Side effects include depression and weight gain.

Aromatase inhibitors--Aromatase inhibitors keep hormones such as androstenedione and testosterone from turning into estrogen and block the endometrial tissue from producing estrogen. Without estrogen to feed them, these tissues can't grow. This is a promising endometriosis therapy since studies suggest that it works well and is better tolerated than other hormone therapies.

While the hormone therapies can reduce or eliminate the symptoms of endometriosis, they stop you from conceiving. Surgery can both cure your pain and help you conceive.

Conservative Surgery--Conservative surgery takes away the growths, scars, and adhesions. Surgery is done either by laparascope or abdominal surgery for more severe cases.

Hysterectomy--When all else fails, total hysterectomy and removal of both ovaries may be the right way to go but is considered a measure of last resort meant only for women post child-bearing age, since hysterectomy rules out conception.


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