Hormone Treatments For Endometriosis
As endometriosis responds and grows when exposed to the female hormone oestrogen, a number of hormone treatments attempt to block or at the very least reduce the production of oestrogen in the body. It is important to mention that endometriosis can produce its own oestrogen and because of this not all treatments will be effective, it very much depends on the person. If you are offered the choice of hormone treatment, you should discuss with your doctor what the treatment involves, the pro's and con's, along with possible side effects. Take time to think it over and discuss with those closest to you, before deciding if the treatment is right for you. Hormone treatments for endometriosis work by putting your body into either an artificial pregnancy state or artificial "chemical" menopause. Both are temporary and can be reversed by stopping the treatment. These treatments have no effect on adhesions, and they will not help fertility.
Hormone treatments available for endometriosis are -
- Combined oral contraceptive pill " the pill"
- Mirena coil
- Gestrinone (Dimetriose)
- GnRH analogues
- Testosterone derivatives
The main symptom of endometriosis is pelvic pain. There are various pain management options available -
- Tens machine
- Physiotherapy - Physiotherapists can develop a programme of exercise and relaxation techniques designed to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety.
- Heat packs, hot water bottles
- Ice packs
- Pain clinic - Pain consultants can be very good with finding options that suit your body and the type of pain you are in.
- Painkillers - Simple analgesics such as paracetamol can be used to treat mild pain. NSAIDs such as ibuprofen, mefanemic acid, voltarol, block the production prostaglandins in the body. Prostaglandins occur naturally, in response to disease or injury, and cause pain and inflammation. They have a number of functions including making the womb contract during a period. The womb contracts during a period to help shed the lining of the womb, the contractions can also cause a lot pain, It is thought women with endometriosis produce extra prostaglandins. NSAIDs only work effectively when taken before the pain or contractions start. Common side effects of taking NSAIDs include nausea, vomiting, diarrhoea, stomach upsets and stomach upsets. These side effects can be reduced by taking the drugs with food or milk. Codeine-based painkillers are effective painkillers but can cause constipation and gastro-intestinal upset, which may aggravate symptoms in women with endometriosis.
- Pain modifiers - These drugs work by altering the body's perception of pain. Tricyclic anti-depressants like Amitriptyline, are drugs that are mainly used to treat depression but have found to have an effect on the nervous system and the way the body manages pain. The pain messages travel through the body's central nervous system, but these drugs can help to stop messages from reaching the brain.
- Low FodMap Diet - There has been some success when removing certain food groups from your diet. Make sure you do your research and consult a doctor before changing your diet.
- Vitamins & Supplements - Vitamins and supplements have been found to help relieve some of the symptoms of endometriosis. Melatonin is a hormone found naturally in the body. Melatonin's main job in the body is to regulate night and day cycles, also known as "sleep-wake cycles". Darkness causes the body to produce more melatonin, which signals the body to prepare for sleep. This can be very good if you are having trouble with sleep. Taking melatonin daily for 8 weeks seems to reduce pain and the need to use painkillers. When used for endometriosis , it also reduces pain during menstruation, intercourse, and while going to the bathroom. Palmitoylethanolamide is a vitamin that can be used for pain, neuropathic pain, fibromyalgia and multiple sclerosis. Palmitoylethanolamide is a chemical that can bind to cells in the body and reduce pain and swelling. Research shows that taking a specific type of palmitoylethanolamide can reduce pain in people with chronic pain due to various causes.
Surgical Options For Endometriosis
As a treatment for endometriosis, surgery can be used to alleviate pain by removing the endometriosis, dividing adhesion's or removing cysts.
- Conservative surgery - Conservative surgery aims to remove or destroy the deposits of endometriosis and is usually performed via a laparoscopy (keyhole surgery). The surgeon can either cut our the endometriosis (known as excision) or destroy it using heat or a laser (known as ablation). It is important to know that excision is always better as it tends to have a longer remission period than ablation. Although even the best excision is no guarantee the endometriosis won't return.
- Complex surgery - Depending on the severity of your endometriosis, you may need to have more complex surgery that will involve different organs within the body, such as the bowel and bladder. Complex surgery will often require a multi-disciplinary team such as a colorectal surgeon, and are usually carried out via laparoscopy. Complex surgery should be discussed thoroughly with your doctor. It is also important that this type of surgery is carried out by an endometriosis specialist.
- Radical surgery - More radical approach can be considered if a woman has not responded to drug treatments or conservative surgeries and is not planning to start a family. Radical surgery refers to a hysterectomy or oophorectomy. Hysterectomy is the removal of the womb, and is performed under general anaesthetic. It can be done with or without removing the ovaries. If the ovaries are left in place then the chance of endometriosis returning is increased. Some women need a further operation to remove the ovaries at a later date. Hysterectomy is not the right operation for everyone and is not a decision that should be made lightly. It is important to understand that a hysterectomy with or without the ovaries is not a cure for endometriosis. In fact most ladies with endometriosis who decide to have a hysterectomy end up needing more excision surgery. A hysterectomy also brings with it a new set of symptoms as your body goes into surgical menopause, this is not the same as natural menopause. For more detailed information on surgical menopause please take a look at "The Surmeno Connection" we have included the link at the bottom of this page.