Endometriosis - Part 4 of 4

10 July 2013

Treatment

There are two approaches to treatment: drugs and surgery.

Drugs

These don't cure the condition, but they do suppress the symptoms. There are two types: painkillers (generally mild analgesics an/or anti-inflammatory drugs) and hormonal treatments. The latter are synthetic hormone tablets which inhibit the production of the female hormone oestrogen and so remove the stimulus for the growth of endometrial tissue. The most commonly-used ones in Australia are Provera, Depo-provera, Primolut N and some brands of the oral contraceptive pill. There's also a group of new drugs known as the GnRH agonists, two of which – Synarel and Zoladex – are now available in Australia. Their main problem is breakthrough bleeding (bleeding at times other than the normal period). Also, when the hormones are stopped, the symptoms tend to return.

Surgery

In some cases surgery is the better option. Surgery for endometriosis aims to remove as many implants, cysts, endometriomas and adhesions as possible, and to repair any damage caused by the disease. It can be done during a laparoscopy (see Diagnosis); the surgeon inserts a laser, diathermy or cauterisation instrument along with the laparoscope, and uses it to destroy the implants or cyst. But if the disease is widespread and extensive, laparotomy – involving a much larger incision into the abdomen – might be the preferred option. Laparoscopic surgery involves only a small incision and so leaves a much smaller scar than a laparotomy. There is also less discomfort and a shorter hospital stay (one day, compared to five).

After surgery (using either approach), about 70 per cent of women experience complete or partial relief from their symptoms. But in about 30 per cent of cases, there will generally be a recurrence within twelve months and in as many as 50 per cent, within five years. Generally speaking, the more areas that can be removed at surgery, the better the outcome, but if the disease is extensive, this is harder to achieve at surgery and recurrence is more likely.

In severe or chronic cases, when everything else has been tried and has failed, a hysterectomy may be needed. This involves surgical removal of the uterus and cervix, and in some cases both ovaries and fallopian tubes also (known as a bilateral salpingo-oophorectomy).

You should never suffer in silence, there are so many options today to help you control your endometriosis visit with Dr Paul Stokes and his team at Coastal IVF Sunshine Coast to discuss your options.

Source: http://www.abc.net.au/health/library/stories/2004/03/25/1829440.htm#.UYeMhitgZro