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Are You Receiving the Best Treatment for Endometriosis?

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Ways for eliminating or controlling endometriosis symptoms

According to the American Society for Reproductive Medicine (ASRM), 10 percent of all women have endometriosis, an abnormal growth of tissue outside the uterus. While the cause is unknown, it is thought that it is an autoimmune disorder that prevents the normal clear of menstrual blood that goes backwards through the tubes. The symptoms vary among women. 25% have few or no symptoms, while others experience pelvic pain, heavy menstruation, fatigue, painful intercourse and infertility. And the best treatment for endometriosis also varies by each woman, based on the severity of her case and her symptoms.

The stages of endometriosis

The ASRM identifies four stages of endometriosis. Stage I is minimal with isolated endometrial implants on the uterus and pelvic lining, while Stage II includes superficial implants less than 3 centimeters not invading the ovary or blocking a fallopian tube. Stages III and IV range from moderate to severe with multiple implants and scarring around the fallopian tubes and ovaries, or having an ovarian cyst of endometriosis called an endometrioma.

Because treatment varies by stage, it’s important to work with your doctor to develop a plan of care. To diagnose endometriosis, your doctor will ask you to describe your symptoms, including location and frequency of pain, and precipitating activities. Your doctor may also perform tests, such a pelvic exam, ultrasound or laparoscopy, to confirm diagnosis and/or determine the severity of endometriosis. Visit our endometriosis page to learn more. The only way to definitively diagnose endometriosis is with laparoscopy for direct visualization or sampling.

Common treatment options for controlling endometriosis

Endometriosis is treated with medications, surgery or a combination of the two. Based on symptoms, diagnosis results and reproductive goals, you and your doctor should work together to develop a plan of care that is best for you in the short and long term.

Endometriosis cannot be cured but the lesions of endometriosis can be excised; it can be managed. Remember, it is thought to be a systemic autoimmune disorder, and that is why people with endometriosis have a lot higher chance of getting thyroid dysfunction and rheumatoid arthritis.

Pain medications

If your endometriosis symptoms are mild, your doctor may advise an over-the-counter pain reliever. However, if you are taking the recommended maximum dose and find you still cannot manage your symptoms, it’s time to try another approach.

Birth control to treat endometriosis

For more than 50 years, birth control has been a “go-to” solution to treat endometriosis symptoms. Birth control works by lessening or eliminating menstruation, resulting in decreased endometrial tissue going backwards through the tubes and decreasing the activity of the implants that are already there.

However, for many women, birth control is not a good solution. Here’s why:

  • Birth control may actually mask symptoms of endometriosis by suppressing periods.
  • It impedes reproductive goals for women trying to conceive.
  • Using birth control can result in side effects, such as spotting, bloating, fluid retention, weight gain, headaches, mood swings, blood clots in your circulation and depression – leading to the need for more medication.

Having an operation to remove endometriosis tissue

Removing, referred to as excising, endometrial tissue from affected areas is the best solution. Studies suggest women who have surgery experience a 62.5 percent improvement or resolution of pain by the second period or cycle. Surgery is done laparoscopically via small, 5 mm, incisions in the abdomen.

Excisional therapy, a process that removes endometrial implants or tissue is ideal, regardless if one is trying to conceive. For those trying to conceive, excisional therapy is beneficial. In a study reported by the U.S. National Library of Medicine, nearly 41.9 percent of women who had undergone laparoscopic surgery to treat endometriosis were pregnant within three months, and 80 percent within one year.

Hysterectomy removes what is thought to be the original source of the endometriosis lesions, but it does not eliminate endometriosis. The lesions must be cut out in addition to hysterectomy, otherwise there may be no improvement in symptoms and in some cases they may even get worse. Microscopic sites of endometrial implants may be present and will grow, becoming symptomatic due to the hormones a woman naturally produces. It is only once a woman reaches menopause that her endometriosis will often wither away and become a dormant if it is not excised.

What is the best treatment for endometriosis?

For many women, laparoscopic surgery to remove endometrial tissue reduces the pain and symptoms of endometriosis. While there is no cure for endometriosis, it is the most effective solution. Because each woman experiences stages and symptoms differently, it’s important to work with an endometriosis expert to develop a customized plan of care.

If you suffer from endometriosis symptoms, reach out to the Kaldas Center for Fertility, Surgery and Pregnancy to start a discussion about your health and develop a path toward your wellness and life changing relief.

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