Diagnosing endometriosis can be troublesome. While chronic pelvic pain is an excellent indicator of the condition, only a laparoscopy can determine whether or not you actually have endometriosis. A laparoscope is a tiny, lighted tube that is inserted into you through a small abdominal incision. A surgeon is able to see inside of you through this tube and can insert any tools or instruments she may need to use through the tube. Using a laparoscope allows a doctor to actually see where the misplaced endometrium is. Once a proper diagnosis has been made, a treatment can be suggested.
Although there are a variety of treatments for endometriosis, there is currently no cure. Some treatments are more effective than others and a few have serious side effects. Which method of treatment you choose is up to you but be sure to discuss all your options with your doctor.
Surgery: Surgery is one of the most effective methods of treating endometriosis so long as all the endo has been removed from the offending areas. If it is not removed, future surgeries will be necessary. Because laparoscopy is the least invasive procedure, this is usually the method of choice for surgeons. It also allows the surgeon to see whether or not all the endometriosis has been removed plus the procedure can be done on an out-patient basis. Other out-patient surgical methods include laser ablation and vaporization.
A laparotomy is a more invasive surgical procedure that requires a hospital stay and has a longer recovery period. In extreme cases, a hysterectomy that includes the removal of all growths and the ovaries may be necessary.
Medications: Some doctors may recommend using a strong, over-the-counter drug or prescribe a pain medication to help ease the discomfort endometriosis can cause. Drugs that have been designed to specifically treat endo usually help by postponing ovulation, thereby regulating the production of estrogen in the body. However, some can only be taken for a short time in order to avoid other health problems.
GnRH agonists are one of the drugs that were designed to treat endometriosis. It works by forcing the body to go into menopause. By reducing the amount of estrogen in the body, the endometriosis lesions shrink and the pain is reduced or stopped. Although it can be helpful for some women, others have found the drug to have little affect on them.
Those who do take the drug can only do so for up to six months and the endometriosis almost always comes back once the medication is stopped. Additionally, the side effects can be quite bothersome and include hot flashes, vaginal dryness, headaches, depression, insomnia and memory loss.
Testosterone derivatives are another medication that was developed just for endometriosis. Like GnRH agonists, testosterone derivatives aim to lower the amount of estrogen in the body. Side effects of this medication include acne, reduced breast size, weight gain, and abnormal facial and body hair growth. Although it is rare, a woman’s voice may also deepen. Most of the side effects are temporary but some may be permanent. This drug cannot be used for more than six months.
Birth control pills have also been used to help women suffering from endometriosis. Often, doctors will recommend taking the hormone pill continuously, with no breaks for the sugar pills. However, there is some controversy as to just how long a woman can safely take the hormone pills continuously. Some experts say that no break is necessary while others believe that a woman should take a pause every few months.
Natural Treatments: Women who would like to avoid surgery or using hormones can try a variety of natural remedies for endometriosis. Many women have found that changing their diet for endometriosis was very successful. Caffeine, sugar and alcohol are the three most often cited items that women have removed from their diets. Other women have said that following a macrobiotic diet or including lots of organic vegetables while minimizing their intake of processed foods had a big impact on their endometriosis symptoms.
Some women have found certain vitamins to be beneficial in easing their endo symptoms. Increasing your B complex vitamins can help to break down the level of estrogen in your body, while using vitamin E with selenium can lower any inflammation you experience. However, because vitamin E increases estrogen production, not all doctors recommend using it.
Looking to the East, many women have found traditional Chinese medicines and techniques to be helpful. A Traditional Chinese Medicine practitioner can blend Chinese plants and minerals to create your own Chinese tea that will help to relieve the pain. Many women have also used acupuncture and acupressure to ease the pain associated with endometriosis. However, some found these techniques to be more effective than others.
Exercise, yoga and meditation can all help with your general sense of well-being.
Endometriosis and Pregnancy
Endometriosis does affect fertility. Approximately 40% of women with endometriosis are infertile. For some women, having troubles conceiving is the first and only indication that they have endometriosis. However, with proper treatment, it is possible to become pregnant. It is also possible to develop endometriosis after having a baby. If you have endometriosis, discuss your desire to have children with your doctor and how your treatment will affect your fertility.
Revision date: July 9, 2011
Last revised: by Janet A. Staessen, MD, PhD