Endometriosis

It is estimated that one in seven women of reproductive age in the United States is affected by endometriosis. Endometriosis is one of the most common gynecologic disorders. Endometriosis is a condition in which endometrial tissue (the lining of the uterus) grows outside of the uterus. Endometriosis can adhere to the ovaries, the fallopian tubes, and other pelvic organs. Endometriosis can cause extensive pelvic pain and other problems.

The most common symptoms of endometriosis include:

• Pain before and during menstruation;
• Pain during intercourse; and/or
• Heavy or irregular bleeding.

In more severe cases of endometriosis, scar tissue can form on the fallopian tubes and/or ovaries blocking the release of an egg during ovulation. This can inhibit a woman’s ability to conceive. If your provider suspects that you may have endometriosis he/she may want to perform a diagnostic laparoscopy to confirm the diagnosis of endometriosis. Endometriosis can be treated surgically or via drug therapy. In choosing an appropriate treatment option, your physician will consider the following:

• Relieving pain and other symptoms;
• Halting the progression of future lesions;
• Restoring fertility to those patients who have lesions blocking their fallopian tubes and/or ovaries; and
  Preserving reproductive function for future childbearing.

Surgical treatments:

• Conservative Surgery – Conservative surgery is often used for women who still have the ability to get pregnant and wish to become pregnant in the future. This surgery is usually performed laparoscopically and the physician cauterizes the endometrial lesions to remove them.
• Nonconservative Surgery – Nonconservative surgery is used only in extreme cases because it involves performing a hysterectomy. This is not a valid option for any woman who wishes to retain her ability to have children.

Drug therapy:

• Oral Contraceptives – Oral contraceptives can be used to halt a woman’s ovulation and menstrual cycle, which in turn slows the growth of the endometrium outside of the uterus. This is most often done in women with mild endometriosis.
• Progesterones – High doses of progesterones can interrupt normal ovarian function and reduce the stimulating effect of estrogen on endometrial growth. Progesterones can be injected or administered orally. Like oral contraceptives, progesterones are most effective in mild cases of endometriosis.
• Male Hormone Derivatives – Male hormone derivatives can be used to suppress the body’s production of estrogen and, therefore, slows the growth of endometrial tissue.
• GnRH (Gonadotropin-Releasing Hormone) Analogs – A fairly new treatment for endometriosis, GnRH analogs can interrupt the production of estrogen and slow the growth of endometrial tissue. Lupron Depot is perhaps the most commonly used of the GnRH Analogs.