Treatment Of Endo
If a woman has no symptoms and does not wish to conceive, then no treatment is necessary, and she need only be seen by her doctor every six months to a year to check on the process of the disease.
Otherwise treatment may be necessary for pain relief or fertility enhancement. Treatment choices are not simple, however, and depend on the age of the woman and her desire to have children.
If a woman has only mild symptoms and infertility is not a factor, simple pain killers like tylenol or tylenol with codeine may be all that is necessary.
For some women with painful periods, drugs which inhibit the production of prostaglandin may be useful to relieve pain. These drugs offer good pain relief for certain women with mild to moderate pain during periods.
For more serious symptoms or those that do not respond to other simpler treatments, and to increase the chance of pregnancy, hormonal treatments may be considered. The aim of these treatments is to stop the ovaries from working and producing estrogen and also to stop the periods.
It has long been believed that pregnancy can improve the condition as well as cause endometrial implants to shrink. This has never been proven. Due to the associated infertility, increased miscarriage rate and possible painful sex, it may be difficult to get pregnant in the first place. Once pregnant, a woman usually experiences relief from pain, at least until the pregnancy is over. Then, the pain and other symptoms may return as before. One study of pregnant women with endometriosis showed multiple discomforts during pregnancy and a higher incidence of difficult labour and postpartum depression. Breast-feeding was found to delay the return of symptoms.
A decade ago, endo was thought to occur mainly in older women in their 30's or 40's and traditionally in white career women of upper middle class status who had delayed marriage and child-bearing. With the widespread use of laparoscopy this has been proven to be only partially true. It also occurs in black women, young women and women who have had early pregnancies. It can even happen in teenagers.
Dr. Donald Goldstein of the Children's Hospital in Boston studied 140 teenagers aged 10.5 to 19 years old who had chronic pelvic pain. Thirty five percent turned out to have endometriosis. He believes too often teens are treated for symptoms, without a proper diagnosis being made.
Moreover, there is a very significant hereditary factor. A woman whose mother, sister or daughter has endo may be seven times more likely to develop endometriosis then a woman without such a history. Also, the severity and reoccurrence rate of endo is higher in women whose close relatives have endo.
Endo is thought to occur less commonly in women who have been pregnant or who have entered menopause. Based on that assumption, two types of hormonal treatments have been developed, one that mimicked pregnancy, and one that mimicked menopause. Birth control pills and progesterone fall into the first category and danazol and the newer drugs fall into the second.
According to Dr. David Olive, Director of Reproductive Endocrinology and Infertility at Yale University in New Haven Connecticut, an unbelievable 43 percent of physicians are still using the birth control pill as a treatment for endo. In spite of the fact that no valid studies are available on their usefulness to enhance fertility or relieve pain.
Birth control pills are used in single or double strength. Pills that contain a high progesterone content are preferred. Side effects are numerous and recently smaller doses were found to produce the same results.
Progesterone by itself has also been used to create a pseudo pregnancy. However, breakthrough bleeding, nausea, weight gain and depression are troublesome possible side effects.
Another hormonal treatment that is commonly used to produce a pseudo-menopause is danazol. Firstly, it is very expensive, costing $95.00 to $190.00 per month depending on the dosage. Secondly, it can cause some unpleasant side effects including weight gain, fatigue, depression, oily skin and acne, decreased breast size and development of facial hair. This last side effect does not necessarily reverse after treatment stops.
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