Treatment
Treatments for endometriosis aim to:
- relieve pain
- shrink endometriosis or slow its growth
- remove the endometriosis
- maintain or restore fertility
The type of treatment will depend on the women's age, the severity of the disease and her symptoms, and whether she wants to have children. Without treatment endometriosis stays the same or gets better in most women, with the passage of time. In about one in three women the condition tends to worsen.
Pain relief:
Painkillers (such as Paracetamol and Codeine) or anti-inflammatory (such as Ibuprofen, Mefanarnic Acid, and Diclofenac), or a combination of both, may help to control the pain if symptoms are mild or moderate.
Hormonal treatment:
Just like the normal endometrium, endometrial cells in other sites need the female hormone oestrogen to survive and grow. Hormonal preparations that reduce the amount of oestrogen in the body will reduce the size of the endometriosis. Examples include the pill, progesterones, danazol, gestrinone, and gonadotrophin releasing factor (GnRH).
All of these hormonal medicines work well but have different side-effects. It may be necessary to try several medicines to see which one works best with the least side-effects.
Surgery:
The aim of surgery is to remove as much of the endometriosis as possible, while maintaining the women's ability to have children, if this is a consideration.
Surgery is usually recommended if:
- plaques of endometriosis are larger than 4-5 centimetres
- there are many fibrous adhesions, or they are interfering with the normal workings of internal organs such as the bowel
- the endometriosis is blocking the Fallopian tubes and causing infertility
- There is severe pain which can not be controlled with painkillers or hormone therapy.
The endometriosis may be cut away, or destroyed with heat produced by an electric current (diathermy), or by laser therapy. This can usually be done via the laparoscopes, using small cuts in the abdomen ("key-hole" surgery). Alternatively and "open" operation may be required via a larger incision (laparotomy).
Amended November 2008
