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Endometriosis. Are there any solutions?

woman looking into camera endometriosisEndometriosis is a common problem that affects 2 million women in the UK.* If the symptoms are not severe, you may not need any treatment other than pain relief

If you need more help, treatment will depend on your age, symptoms, whether you intend to get pregnant and what treatment you have had previously.

If you don’t wish to become pregnant, you could try hormonal treatments, which aim to reduce oestrogen which encourages endometriosis to grow. Hormone treatments available are:

  • The oral contraceptive pill is probably the easiest to take but doesn’t suit everyone
  • Danazol blocks the effects of oestrogen on tissues but also acts as a weak male hormone, so it can cause side effects of acne and unwanted hair
  • Gonadorelin analogues such as buserelin nasal spray are designed to simulate menopause, thereby halting the cycle and possibly shrinking endometrial implants

For women with mild endometriosis who wish to become pregnant, the best course of action is to have a trial period of unprotected intercourse for six months to one year. If pregnancy does not occur within this period then further treatment may be needed.

Women who want to become pregnant more quickly, who have severe physical changes or debilitating pain, may need more powerful treatment, possibly surgery.

Conservative surgery attempts to remove the diseased tissue without risking damage to healthy surrounding tissue. This procedure is usually done under anaesthetic through a laparoscope: a device like a tiny telescope that is inserted into the abdomen. Some patients may need more radical surgery, such as hysterectomy, to correct the damage caused by untreated endometriosis. If the ovaries are badly damaged, hysterectomy and removal of the ovaries may be the only treatment possible.

To sum up, endometriosis is a long-term disorder. Because it affects each woman differently, it is essential to maintain a good, clear, honest communication with your doctor. The truth about this disease is that there are no clear-cut universal answers. If getting pregnant is an issue, then age may affect the treatment plan. If it is not, then treatment decisions will depend primarily on the severity of symptoms.

Diagnosing endometriosis

Diagnosing endometriosis can be difficult as symptoms can vary considerably between individuals and are the same as the symptoms of other conditions. Definitive diagnosis is only possible by laparoscopy – a surgical procedure involving a general anaesthetic. If left untreated, it is almost certain that the extent or severity of endometriosis will increase, therefore it is important to obtain a diagnosis as quickly as possible.

*NHS statistics

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