Treating Endometriosis
There are several options for treating endometriosis, and each has its place for different women's disease. The options are as follows:
- No treatment at all
- Management of symptoms
- Medical management
- Conservative surgery
- Radical surgery
If endometriosis is found, for example, at the time of laparoscopic sterilisation and it is only mild, causing no symptoms at all, then it is quite reasonable to leave well alone and avoid any treatment at all.
Symptom Management
Management of the symptoms means using painkillers to make the painful periods more tolerable or for cyclical pain if it is not too bad. Some of the pain is caused by hormones called 'prostaglandins' which make the uterus contract. Ibuprofen and mefanamic acid (Ponstan) are anti-inflammatory drugs that reduce levels of prostaglandins and often help with the pain. If there is not prompt response to analgesics, it is sensible to move onto some hormonal treatment, that will actually shrink the endometriosis itself, or to consider one of the surgical approaches.
Assisted Conception
If endometriosis is associated with infertility, another way of 'managing the symptoms' is to use assisted conception (in-vitro fertilisation or IVF, sometimes called 'test-tube baby'). This won't deal with the endometriosis, but the approach might be suitable for a woman with minimal other symptoms, who is older & doesn't have as much time to undergo prolonged treatments or sit around on a waiting list for surgery. Also, if other treatments have failed and infertility persists, assisted conception is usually the only remaining option.
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