Treatment of endometriosis: surgery, drugs, self-care


Endometriosis is a disease in which tissue similar to the endometrium grows outside the uterus, causing pain, infertility, and other symptoms.

Treatment for endometriosis may include a combination of the following:

  • self treatment
  • dosage
  • surgery
  • pelvic physiotherapy
  • Treatment of comorbidities

Learn more about treating endometriosis in this article.

Illustrated by Mila Norian for Verywell Health


What are the goals of endometriosis treatment?

In most cases, the goal of endometriosis treatment is to manage disease-related symptoms and prevent progression. There are several different approaches to treating endometriosis.

Endometriosis can be associated with pelvic pain, pain during intercourse or bowel movements, and abnormal bleeding. Occasionally, the symptoms become severe and the person’s quality of life is significantly reduced. There is no cure for endometriosis, but there are ways to manage symptoms.

For people with endometriosis-related infertility, one of the goals of treatment may be to improve the chances of conception.

Endometriosis can also cause adhesions (scar tissue) that disrupt the alignment of internal organs. Another goal of endometriosis surgery is to repair and restore the natural anatomy, which can benefit both symptoms and fertility.

Factors Determining Endometriosis Treatment

Not everyone has the same endometriosis treatment plan. Many factors can influence a treatment plan, including symptom profile, fertility, health insurance, and personal preferences.

Treatment of endometriosis often begins with medical management. In more severe cases or when drugs do not work, excisional surgery is another option. Endometriosis surgery is more invasive, costly, and carries more risks, but it is highly effective in reducing the symptoms of endometriosis. Endometriosis surgery can be complicated, so it’s a good idea to find a doctor who specializes in endometriosis surgery.

It is important to obtain full informed consent from your healthcare provider when deciding how to treat endometriosis. Discuss all possible side effects and complications of surgery and medications.

Treatment and diagnosis of endometriosis

A definitive diagnosis of endometriosis is possible only through surgery. A surgeon can perform an excision (excision) and analysis through a pathologist to confirm the diagnosis. Removal of the tissue implant can be both diagnostic and therapeutic.

Treatment options for endometriosis

There is no cure for endometriosis, but there are several strategies to manage symptoms. It includes surgical management to remove tissue, excision of adhesions or scar tissue, and restoration of anatomy.

resection surgery

If you have severe pelvic pain, gastrointestinal symptoms, infertility, or symptoms of endometriosis and do not respond to treatment, remove endometriosis, remove scar tissue, and restore internal anatomy Surgery may need to be considered.

However, few specialists perform this advanced surgery, and some of these specialists do not have health insurance, which can make access to medical care more difficult. These specialists often collaborate with other surgical specialists, such as colorectal surgeons, to perform more complex surgical procedures.

ablation surgery

This more common method of endometriosis surgery burns rather than excises the surface of the lesion.

Ablation carries a higher risk of thermal damage to surrounding tissue, a higher risk of postoperative adhesions and pain, and may be associated with a more significant inflammatory response than resection. A systematic review found that ablation was not as effective as resection in terms of improving pain symptoms one year after surgery.

pain reliever

If you are reluctant to have surgery, or if there are financial barriers to having surgery, your health care provider may prescribe pain relievers to help manage your symptoms.

contraception

Because the spread and growth of endometriosis is hormone-dependent, hormonal therapy, such as oral contraceptives and progesterone intrauterine devices (IUDs), can help reduce symptoms and limit the spread of the disease. .

Gonadotropin Releasing Hormone (GnRH) Agonists

Health care providers may recommend the use of gonadotropin-releasing hormone (GnRH) agonists such as Lupron Depot (Leuprolide Acetate for Depot Suspension), which reduces hormones by initiating temporary menopause. I have. This can reduce the symptoms of endometriosis. However, this treatment may have side effects and risks and should be used for a limited period of time.

The course of this treatment is generally limited to 6 months to 1 year due to risks associated with long-term use, including osteoporosis, diabetes, and other metabolic disorders.

pelvic physiotherapy

This form of physical therapy, which focuses on supporting and retraining the pelvic floor, may be prescribed before endometriosis surgery or during the recovery period after surgery. , helps retrain the pelvic muscles, but it does not make endometriosis lesions disappear or resolve.

Will I need multiple endometriosis surgeries?

People undergoing surgery for endometriosis may need multiple surgeries to manage their symptoms. Endometriosis may spread or worsen over time, or it may remain after being completely removed or treated in one operation. If the disease is more advanced and you are concerned about whether surgery is needed, see a health care provider who specializes in endometriosis.

Treatment of secondary endometriosis

Various health conditions can occur with endometriosis or cause similar symptoms. Treatment of endometriosis does not necessarily improve these conditions and symptoms may persist. Similar conditions and their treatments include:

  • Adenomyosis: Often called the “sister condition” of endometriosis, the endometrium (the inner lining of the uterus) grows into the muscular wall of the uterus, causing painful and heavy menstruation. definitive treatment for Adenomyosis A hysterectomy (surgical removal of the uterus). People who want to become pregnant or who choose not to have a hysterectomy may be prescribed drugs to manage symptoms.
  • interstitial cystitis: Also called painful bladder syndrome, this condition is sometimes treated with drugs that relieve pain, reduce frequent urination, and relax the bladder. Lifestyle changes such as dietary adjustments to avoid bladder irritants may also be recommended.
  • Uterine fibroid: These benign uterine tumors can cause pelvic pain and other symptoms similar to endometriosis. Treatment includes surgery to remove fibroids, a hysterectomy, medications to control symptoms, and lifestyle changes.

Can endometriosis be cured after a hysterectomy?

It is an unfortunate myth that a hysterectomy is a cure for endometriosis. A hysterectomy is an operation to remove the uterus, and by definition, endometriosis is a disease that exists outside the uterus. Studies have also shown that removal of the uterus does not always lead to better results than surgical removal of the uterus.

How do you treat endometriosis at home?

Many people with endometriosis have learned how to manage their symptoms at home. Home treatments for symptoms of endometriosis include:

  • Apply a hot water bottle or electric heat pack
  • Application of ice pack
  • Wear loose-fitting clothing without a waistband
  • Drink tea (peppermint, spearmint, chamomile, turmeric, or green tea)
  • gentle pelvic stretch
  • over-the-counter pain relievers
  • Apply topical pain relievers or lotions
  • Massage
  • acupuncture
  • traditional chinese medicine
  • Eat a low-fat, minimally inflammatory diet

Complications of untreated endometriosis

Endometriosis can cause debilitating pelvic pain and other symptoms and affect a person’s health, mental health and quality of life. Symptoms also affect your financial health. Several studies have evaluated the economic impact of endometriosis. They show that endometriosis can lead to high medical costs and reduced income due to lost productivity from pelvic pain.

As endometriosis progresses, it can lead to inflammation, scarring, blockage of the fallopian tubes, and even infertility. Endometriosis also affects fertility and implantation rates. If you have endometriosis and want to conceive, it’s important to talk to your fertility doctor.

Chronic pelvic pain from endometriosis can cause long-term problems with the pelvic floor, affecting sex, bowel movements, and urination. Pelvic floor physical therapy may help.

Successful Endometriosis Treatment by Experts

If you need surgery for endometriosis, it’s important to work with a surgeon who specializes in endometriosis.

Find an endometriectomy specialist with the following skills:

  • resection
  • Recognize all possible colors and appearances of endometriosis
  • Evaluation of the entire pelvis and extrapelvic regions (rectovaginal cavity, appendix, bladder, liver, diaphragm, kidneys, intestines, etc.)

summary

Endometriosis treatment includes medical strategies and surgical approaches. Hormone therapy, pain relievers, lifestyle changes, and pelvic physical therapy are often frontline interventions. If endometriosis symptoms are severe or do not respond to minimally invasive strategies, surgery may be considered. If so, finding a healthcare provider that specializes in endometriosis is important. is.



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