SJP Nutrition
Endometriosis - Treatment and Management
Treatment and Management of Endometriosis
It can be difficult deciding between the various treatment options. Treatment of endometriosis includes management of symptoms, surgical diagnosis, surgical removal of disease, and identification and management of additional conditions that cause pelvic symptoms.
Choices of treatment can be influenced by the severity of your symptoms, your age, and whether fertility is an issue. The option to watch and wait is good if you are trying to have children, only have mild endometriosis with bearable pain levels, or for woman who are approaching menopause.
Be sure to have regular consultations with your doctor. It is also a good idea to keep records of your symptoms with a pain diary, so that you can look back on each month to see if your symptoms are changing.
The 3 main options are:
See how your symptoms develop. Have regular checks with your doctor
Treat the symptoms with medication, hormones and painkillers
Surgery, Follow up Checks, Other treatments
Medical treatments
Your doctor may suggest medical treatment of your symptoms with contraceptive pills, or various other hormonal medications like:
Depo-Provera® (progesterone injection), Mirena® (IUD), or implanted progesterone (Nexplanon®), or hormonal medications to induce a menopausal state including: GnRH agonist/antagonists (Lupron®, Orilissa®, Synarel®, Zoladex®), androgens (Danazol®).
Hormonal medical treatments only treat symptoms. They are used to try to regulate your menstrual cycle, and to try to lessen the symptoms. They can sometimes help to slow the growth of endometriosis and give you some relief from the symptoms, but they are not a cure, they are more of a band-aid. They do not remove or treat the disease, and they can have significant long-term side effects.
Hormonal medications can have possible side effects such as: weight gain, acne, depression, mood swings and irregular bleeding. So make sure you discuss all the options with your doctor, so that you can make the best and most informed decision.
Your doctor can also offer a wide range of pain relief options and anti-inflammatory medication.
Excision surgery is the Gold-Standard treatment to completely remove the disease, by complete excision of abnormal tissue. The surgeon aims to completely remove endometriosis by surgically cutting out all of the disease at its roots. This method seeks to restore normal anatomy and preserve organs when possible. Recurrence rates are low when this procedure is done by surgeons skilled in identifying all forms of endometriosis, and removal of endometriosis wherever it is found.
Surgical treatments that do not eradicate endometriosis
Ablation surgery is common. This is a surgical technique that attempts to destroy endometriosis lesions, by burning the surface of the lesion. However, it can often leave disease behind, under the ablated areas, and it also does not allow for the tissue to be confirmed by a pathologist.
Incomplete excision surgery: when the surgeon misses seeing the abnormal tissue/lesions, leaving the disease behind.
Hysterectomy
Hysterectomy is often considered in severe cases of endometriosis, if fertility is no longer a consideration. It is also an option for treating adenomyosis (endometriosis in the uterus wall). A hysterectomy may help to eliminate your endometriosis symptoms, especially if all the endometriosis lesions are removed. Then your symptoms should disappear or improve.
However, if some abnormal tissue is missed, you could continue to have endometriosis symptoms, even after a full hysterectomy. So while a hysterectomy may help to eliminate or reduce some painful symptoms, it is not a cure for endometriosis. Therefore, a decision to proceed with a hysterectomy must be very well considered.