What is Endometriosis and How is it Treated?
Endometriosis is a female gynecological disorder which occurs when the endometrium grows outside of the uterus. With endometriosis, many patients experience painful endometrial implants commonly located on the woman’s ovaries. While rare, implants have been diagnosed in areas outside of the abdominal cavity, such as in the lungs or the brain.
According to the Center of Disease Control (CDC), approximately 6 million American, or 15% of women suffer from endometriosis. Most women are diagnosed with endometriosis (which can only diagnosed after a laparoscopic biopsy procedure) after reporting to their practitioner of having severe abdominal pain, heavy periods, or infertility. Other symptoms of endometriosis include: lower back aches (especially during menstruation),, spotting in between menstrual cycles, severe menstrual cramps, pain during intercourse, bleeding after intercourse, constipation, pain with bowel movements, rectal pain, and blood in the stool or urine.
Some women who have endometriosis may never experience severe or even any side-effects of the disease. These women are diagnosed in a myriad of ways, such as it being discovered after a c-section, or another surgery in the abdomen, for some other reason than endometriosis. For this reason, some women choose not to seek any treatment, especially since many of the effective treatments of endometriosis produce very harsh and long lasting side-effects. However, most women with endometriosis do seek medical treatment because up to 40% of endometrial sufferers experience infertility.
There are many theories on why some women get endometriosis and some don’t. There does seem to be a genetic link involved since endometriosis does appear to run in families. Another theory is that endometriosis is caused by the backing up of menstrual blood into the fallopian tubes. Some medical experts claim that endometriosis is a hormonal or immune system deficiency. Lastly, there is a common (but seemingly bizarre) theory that endometriosis is caused by leftover tissue when the woman was embryo.
Doctors first recommend trying to treat the symptoms of endometriosis through non-medication at home. Many women find that applying heating pads to the lower stomach area helpful since heat can aid in stimulating blood flow to the region, and a hot bath would also have the same effect. Another way of stimulating blood flow to the pelvic region is by cardiovascular activity. Many women have claimed relief from cramps, backaches and other endometrial symptoms after they worked out, mostly because of the feel-good hormone called endorphins.
For other home treatments, a woman could lay on her side with a pillow in between her knees; this will place less pressure on the reproductive organs, and can help with any backaches. Lastly, some women have claimed relief after having intercourse while on the menstrual cycle. Additionally, studies have shown the having sex during menstruation can quicken the time of the menstrual cycle.
If home treatments are not working, or if the woman is still infertile, it is time to go back to the doctors. The irony is that one of the easiest ways to treat endometriosis all naturally is getting pregnant. That wouldn’t be so hard if one of the symptoms of endometriosis were not infertility. This is why when a new patient goes to the doctor asking for treatment the doctor will most likely ask if the patient is in a place in their life where getting pregnant would be a wise choice. If it is, he or she will send you home to see if you can get pregnant on your own. If you can’t conceive after a year, its time to go back to the doctor.
There are a lot of medications that a doctor can prescribe to help treat endometriosis, but doctors routinely start with medications with no, or at least the fewest side-effects. This is why birth control is commonly the first step in treatment. It may seem like an oxymoron for a women to go on the pill when she hopes to get pregnant, but it is one of the fastest ways, with no harm done to your body.
However, many women see drastic improvements with the pill, patch, or shot within six months and subsequently taken off of it if the woman believes it is the right time to start a family. Their abdominal cavity in theory should have few to no lesions or endometrial implants (because of first the surgery, and second the medicine) making it much easier to conceive. For those not wanting to get pregnant any time soon, most of these patients just stay on the pill, patch, shot, if it treats their symptoms well. If the patient does still experience pain, routinely doctors will write a prescription for pain medication.
If home remedies do not help, and pregnancy is not an option, or you can’t get pregnant, the birth control pill did not work effectively enough, many doctors will now move on to Lupron or Depo. Lupron, and medication like Lupron work by shutting down the ovaries and lowering estrogen levels, which forces the woman in temporary menopause. Lupron comes in two strengths, one injection will last for three-months, while the other lasts for six-months. You will want insurance for Depot and Lupron, retail price is $1,200 for one injection.
Lupron and Depo is only designed for women who experience the dire-of-dire symptoms of endometriosis. Reason being, if a woman is given Lupron or Depo during a woman’s peak of childbearing years, it immediate shuts down, like when someone pulls the emergency break on the train quickly, it will place the human body incredible stress. One day they are in their prime, normally in their 20’s and 30’s, then all of a sudden the woman is in the heaps of menopause. It’s not pretty. Side-effects from Lupron and Depo include: severe mood changes, depression, suicidal thoughts, hot flashes, profuse sweating all over the body, body aches, painful joints, symptoms of the flu, lethargy, difficulty breathing, itching, and vaginal discharge.
Surgery is considered a last case scenario. Surgery occurs only if pain medication (including narcotics) is not able to stop or relieve the severe pain, the endometriosis is starting to complicate the functions other organs in the abdominal cavity (especially the kidneys), or if the woman has proven that she is infertile. Most doctors will not classify a woman as infertile until she has tried frequent unprotected sex without success for a one-year period. Women under the age of 35 are diagnosed as infertile if they are not able to conceive within six months, due to their shrinking window of opportunity to get pregnant.
When women are first diagnosed with endometriosis, they will get a laparoscopic procedure in which the doctor will get a biopsy of the endometrium, and while the surgeon is still inside and visually sees the endometriosis he or she will burn them away. So when most women are being diagnosed, the doctors are simultaneously treating the patient. However, having a laparoscopic procedure does not cure endometriosis, it will grow back. Women who continually have severe side-effects of endometriosis will often get surgery to burn away the endometrial lesions every year or two.
Normally, after the surgery the doctor will immunize her with Lupron or Depo to slow down the growth rate for the endometrial lesions to return. If home treatments, birth control, Lupron or Depo still does not help the patient, or they do not want to have any more children, many women will get a hysterectomy. Though rare, some women who have had a hysterectomy will still develop endometrial lesions, but these lesions are more easily detectable and treated because of the lack of reproductive organs in the pelvis.
To conclude, approximately 15% of the women in the United States have endometriosis. For those who suffer from the severe symptoms of endometriosis there is hope through home treatments, pregnancy, medication, and surgery. Researchers are discovering new treatments for endometriosis, and hopefully one day will not only have a cure for the disease, but we may even develop an immunization to prevent it.
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