Endometriosis Treatment

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Endometriosis treatment

        Endometriosis treatment requires first the diagnosis. There are several types of medical or surgical treatments. Surgery is reserved for severe cases of endometriosis. Infertility is very common. A woman suffering from a mild endometriosis is likely to remain pregnant up to 40-60% after treatment. Lesions removal is reestablishing reproductive function and significantly increases the chances of pregnancy.

Conservative endometriosis treatment (medical)

       Medical studies have shown that endometriosis lesions may regress during pregnancy, which result in the use of endocrine therapy hormone in the endometriosis treatment. Administration of large amounts of the hormone progesterone will induce endometrial atrophy.

       Oral contraceptives taken continuously for seven days without break are relieving endometriosis symptoms by blocking ovulation, such as the endometrium is suppressed and is no monthly bleeding. The absence of menstruation prevents formation of new lesions and cause atrophy of existing ones.

       Medicines containing gonadotropic hormone agonist, decrease estrogen and progesterone level. They mimic the physiological changes that occur in menopause. Menopause is often associated with regression of lesions and symptoms of endometriosis. Administration of gonadotropin hormone-like, may also cause symptoms similar to those of menopause: hot flashes, vaginal dryness, decreased libido, early osteoporosis.

       For those reasons, this treatment is recommended only for 3-6 months and will then be interrupted or otherwise replaced with other treatment. Radical surgery consists in practicing a hysterectomy (surgical removal of the uterus) or anexectomy (removal of ovaries).

Symptomatic endometriosis treatment

       Most symptoms are painful endometriosis. There are several ways to alleviate discomfort caused by pain of endometriosis:

• Bed rest, avoidance of excessive physical efforts
• Baths, showers and hot compresses to relieve pain
• Avoid chronic constipation because it emphasizes the pain of endometriosis and menstruation. It is therefore recommended daily consumption of generous amounts of fiber (cereal, fruit, vegetables).
• Learning and practicing relaxation techniques that increase resistance to pain (yoga, visualization techniques, special breathing exercises)
• Analgesics and anti-inflammatory medication: indomethacin (suppository), phenylbutazone, diclofenac, ibuprofen, etc.

Drug therapy

       Endometriosis treatment associated with surgical and medical techniques will be chosen depending on the severity of signs and symptoms, and the patient desire to have kids.

Analgesics

       Analgesics or nonsteroidal anti-inflammatory drugs such as ibuprofen may be prescribed to relieve pelvic pain caused by endometriosis. Sometimes a hot bath or a heating pad is sufficient to reduce pain.

Hormonal treatments

       The hormone treatments do not treat the endometriosis, but they can often relieve the pain.

       The increase in estrogen levels during the menstrual cycle causes endometrial thickening. The drop in estrogen at the end of the cycle causes the degradation of endometrial tissue in the form of bleeding. The hormone treatments, by blocking the production of hormones by the ovaries, reduce bleeding. These treatments do not increase fertility.

       Here are the most frequently used hormonal treatments.

With contraceptive

        Birth control pills taken continuously (every day, without the usual week of interruption) relieves pain in a number of women, reduces the amount of menstruation, and prevents estrogen deficiency.

The IUD

       It is an intrauterine device covered with a progestin. It significantly reduces menstrual periods and pain associated with endometriosis. It should be changed every five years. Possible side effects: spotting may occur during the cycle, especially during the first months of use.

Medroxyprogesterone acetate

        It consists in injecting a progestin (a substance promoting the process of pregnancy) in a muscle every three months. The injected hormone inhibits ovulation and menstruation and reduce pain associated with endometriosis. Possible side effects: weight gain as well as spotting during the cycle. The use of medroxyprogesterone acetate is sometimes associated with mood changes, and the return of ovulation may be delayed in some women at the time of discontinuation.

Without contraceptive effect

       Danazol raises an artificial menopause by blocking the secretion of estrogen by the ovaries. It is used to relieve pain. It causes a cessation of menstruation in the majority of women who use it. Treatment usually lasts six to nine months. Possible side effects: a slight weight gain, hot flashes, vaginal dryness, sometimes androgenic effects (acne, facial hair). These effects disappear upon discontinuation of treatment.

       Analogues of GnRH hormones act on the pituitary, but at an earlier stage, that is to say, they block the activation of the pituitary hormones of the hypothalamus (the Gn-RH for "gonadotrophin releasing hormone "). They also induce menopause. They are administered by injection every month. Usually, the duration of treatment does not exceed six months. Possible side effects: hot flashes, headaches, mood swings, bone mineral loss in the short term.

Aromatase inhibitors

       These inhibitors used to treat breast cancer may be effective in endometriosis treatment. Aromatase inhibitors block the conversion to estrogen and testosterone hormones. Thus, the body is deprived of estrogen required for endometrial proliferation.