Contents
Medical treatments for endometriosis
Currently there is no no definitive treatment of endometriosis. THE’hysterectomy does not guarantee the permanent disappearance of symptoms, since endometriosis can form “spontaneously” in other areas of the body. It is important to see a doctor early when symptoms of endometriosis develop, because the earlier the disease is diagnosed, the better it is treated. It also decreases the risk of infertility. It should be noted that the symptoms mentioned above may indicate another disorder of the reproductive system, the presence of ovarian cysts, for example. A pelvic ultrasound will detect them quickly. The following treatments are often used in conjunction with each other. |
Analgesic drugs
Medical treatments for endometriosis: understand everything in 2 min
Ofacetaminophen (Tylenol®) or anti-inflammatory, such as aspirin or ibuprofen (Advil®, Motrin®), can be used to relieve pelvic pain caused by endometriosis. If needed, anti-inflammatory drugs may be prescribed by the doctor (for example, Naprosyn®).
Sometimes a bath chaud or a heating pad are sufficient to reduce the pain.
Hormonal treatments
Hormonal treatments can help ease the pain. However, they do not treat the problem and do not influence fertility. They work by blocking the production of hormones by the ovaries, which reduces bleeding.
Here are the most frequently used hormonal treatments.
With contraceptive effect
Birth control pills. The contraceptive pill taken continuously (daily, without the usual week off) relieves pain in a number of women, reduces the amount of menstruation, prevents estrogen deficiency, and provides birth control, while generally being well tolerated. The hormones released by the pill block ovulation and prevent the pituitary from releasing stimulating hormones to the ovaries by the pituitary gland.
Mirena® IUD. It is an intrauterine device coated with a progestin. It fits into the uterus like an IUD. It significantly reduces menstruation and pain associated with endometriosis. It should only be changed every 5 years.
Possible side effects: spotting may occur during the cycle, especially during the first few months of use.
Medroxyprogesterone acetate (Depo-Provera®). A progestin is injected into a muscle in the buttock every 3 months. The injected hormone inhibits ovulation and it reduces or abolishes menstruation and pain associated with endometriosis.
Possible side effects: sometimes significant weight gain is observed in some patients, as well as spotting during the cycle. The use of medroxyprogesterone acetate is sometimes associated with mood changes, and the return of ovulation may be delayed in some women when stopping treatment.
Without contraceptive effect
Danazol (Cyclomen®). Danazol induces an artificial menopause by blocking the secretion of estrogen by the ovaries. It is used to relieve pain. It causes an end to menstruation in the majority of women who resort to it. Treatment usually lasts 6 to 9 months.
Possible side effects: slight weight gain, hot flashes, vaginal dryness, sometimes androgenic effects (acne, facial hair). These effects disappear when the treatment is stopped.
Gn-RH analogues (Lupron®, Zoladex®, Synarel®). These hormones block the activation of the pituitary gland by hormones from the hypothalamus (Gn-RH, for “gonadotrophin releasing hormones”). They also cause menopause. They are given by injection every month. Usually, the course of treatment does not exceed 6 months.
Possible side effects: hot flashes, headaches, vaginal dryness, mood swings, short-term bone mineral loss.
Exercise to reduce the side effects of drugs? 4-week clinical trial indicates exercise is an effective way to minimize stress androgenic effects (acne, facial hair) from treatment to danazol5. For the purposes of the study, the researchers formed 2 groups of patients: one received danazol, the other received danazol in addition to practicing 4 exercise sessions each week (40 minutes per session). While all of the women – 39 participants with endometriosis – saw their symptoms decrease, those who exercised had fewer androgenic side effects. Another 12-month study indicates that physical training helps women who take a analogue of Gn-RH to reduce bone mineral loss caused by this medicine6. |
Surgical treatments
Conservative surgery. In order not to compromise the chances of pregnancy of women wishing to have children, to increase fertility or even in the case where the pain is refractory to drug treatments, so-called “conservative” surgery (which preserves the uterus and the ovaries) is often necessary. carried out. It involves removing endometrial growths, scar tissue and adhesions that are often the cause of infertility. If the endometriosis is not too formed, surgery can be performed laparoscopically. During a laparoscopy, a small incision is made near the navel, and a thin, flexible tube (the laparoscope) is inserted into the abdomen. It is a microscope equipped with a light source and capable of being equipped with an electric current or a laser in order to burn tissue. 70% to 100% of patients experience relief immediately after surgery7. However, the pain recurs over the years for many women.
If endometriosis is widespread, the procedure is sometimes done using a larger incision in the lower abdomen.
Radical surgery. In extreme cases, it may be necessary to remove the uterus (hysterectomy) and ovaries to prevent hormonal stimulation. However, this treatment causes menopause and permanent sterility. It should be considered as a last resort.
Assisted reproduction techniques. When conservative surgery does not allow a woman to regain her fertility, assisted reproduction techniques can be used.
Support group
Recurrent pain, fatigue, worry, and sometimes difficulty getting pregnant, all contribute to irritability, and sometimes anxiety and depression. Participation in a support group allows women to share their experiences with others in the same situation and to be comforted. See the Support Groups section (below).