Endometriosis

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Treatment

Doctors often treat endometriosis using a combination of drug therapy and surgery, and personalize treatment for each woman, depending on the severity of the disease and its location, the woman’s age, if she hopes to get pregnant, and the extent of pain or other symptoms. If you have mild endometriosis, you may need only over-the-counter pain medication or stronger, prescription pain medications. Many drug treatments also focus on decreasing estrogen production to relieve symptoms (endometriosis relies on estrogen for growth), so doctors may prescribe birth control pills or other hormones to halt menstruation for patients not trying to get pregnant.

Endometriosis lesions can often be removed surgically by laparoscopy or traditional abdominal surgery, depending on the number of lesions. In cases of severe pain the nerves around the uterus or pelvis may be severed surgically or a hysterectomy may be necessary; however, the lesions may not be confined to the reproductive organs so the endometriosis may return in the case of a hysterectomy. There is no clinical evidence to support the use of alternative therapies in the treatment of endometriosis; however, many women have found relief from symptoms using homeopathy, osteopathy, and Traditional Chinese Medicine.

Infertility

It may take longer to become pregnant if you have endometriosis; and for many women, the condition renders them completely infertile. Doctors often recommend their patients not delay having children because endometriosis is a progressive disease, so the longer you have it, the greater your chance of becoming infertile. Endometriosis can cause infertility for the following reasons:

• Scar tissue from endometriosis can form adhesions on the ovary and limit the release of eggs.
• New research has shown that women with endometriosis-related infertility lack a certain enzyme in their uterus that allows an embryo to attach to the uterine wall, thereby preventing pregnancy.
• Adhesions affecting the fallopian tubes may interfere with their ability to pick up an egg released by an ovary and transport it to the uterus.
• Lesions may form inside a fallopian tube, blocking it and making fertilization impossible.
• Endometriosis can disrupt the ovaries' normal cycle of egg development and release.
• The peritoneal fluid in women with endometriosis contains an increased number of scavenger cells, which have the ability to destroy sperm cells, making fertilization unlikely.
• In advanced stages of endometriosis, internal organs may fuse together causing a condition known as a “frozen pelvis.”

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