Endometriosis, the sleeping giant UPDATE (My Experience Of Endometriosis)

Member Name: drdel

Product:	My Experience Of Endometriosis
Date:	30/07/01 (654 review reads)
Rating:

Advantages: resolves after menopause

Disadvantages: painful, can be difficult to treat

Just thought I would update my old medical ops, people seem to find them useful. I hope this will prove beneficial to others.

Endometriosis is a condition that affects a great many women that I see daily as a gynaecologist working in London. Most people fail to understand how distressing this condition can be to women and how much pain they can be in.

I have also found that endometriosis has been poorly explained to patients I have seen so I hope this op will be useful to those suffering with this and those who have friends or family that do.

A bit of background first some of this I am sure some of you already know but I think it is beneficial to those who may not be fully aware of endometriosis.

What is it? The lining of the womb that is shed during a period is called the endometrium. It is usually only found in the womb. In endometriosis, this tissue is found elsewhere in the pelvis. Common sites include the ovaries, fallopian tubes and parts of the pelvis wall. When a woman has a period those areas also bleed as well as the normal site and his can be very painful. If the endometrium is found in an ovary, it will bleed into an ovary and cause a cyst to form which is full of old blood. Women commonly therefore complain that their periods are painful and sometimes experience pain during sex as pressure is put on spots of endometriosis that exist on the pelvic walls.

Very rarely there can be endometriosis in other sites such as the lung causing patients to cough up blood during their period.

The only way to diagnose this condition is by doing a Laparoscopy. A small camera is passed into the pelvis where endometriosis can be seen.

So what are the treatments. Well the endometriosis spots reaact to the hormonal changes during your period so medications are directed towards that. The pill stops the hormone fluctuations. If you are pregnant endometriosis tends to improve because there is no cycle going. Other
drugs are directed at suppression of the cycle such as Danazol and Progesterone.

Surgical treatments include using a laser top burn off spots in your pelvis and any ovarian cysts can also be removed via the laparoscope method.

Ultimately and unfortunately, this disease is not entirely curable. It tends to recur in some but not all patients. When it becomes very difficult to treat is when a laparoscopy shows no endometriosis and yet patients still report pain during their periods. Drugs like mefenamic acid (Ponstan) can be helpful for period pain. It is sad but some women end up having hysterectomies as a result of endometriosis.

The real approach depends on the individual woman's situation. If she is young and has not had children then efforts must be made to preserve her fertility, so medical treatments are usually employed and if she does not want to have children then usig the pill often works. There are may types of pill and it is worth trying different brands until you find the one that works for you. Danazol is also effective in childbearing women. However if the woman wants to have a child in the near future then obviously contraceptives are not appropriate but when she gets pregnant she should get relief from her symptoms.

In ladies with recognisable endometriosis on laparoscopy, it has been beneficial to use surgical methods, i.e. laser or removing cysts from ovaries. This often but not always resolves symptoms.

If a lady has completed her family or does not want to have children for many years then the Mirena Coil may be useful. This is a coil that is easily inserted without the need for anesthetic and releases progesterone. It is an excellent contraceptive that is also used for heavy periods because it significantly reduces the extent of bleeding and in some women totally ceases bleeding completely. After one year of use 80% of women report that they are very satisfied with the Mirena.

Obviously
each individual case is different and endometriosis can be extremely difficult to get on top of especially when there is no visible pelvic disease but there are treatments out there that can be effective and often it is a case of finding the best one to suit your set of life circumstances.

I hope this has been helpful to some of you and I would be happy to answer any comments or questions you might have.

Thanks for reading.

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