How to Treat Endometriosis?

Treatment for endometriosis depends on the extent of the disease, presenting symptoms, and whether one wants to have children at that point in life. It may be treated with medication, surgery, or both. Although treatments may relieve pain and infertility temporarily, symptoms may come back after treatment.

 Medications- is used both to relieve pain and to keep the disease under control. Painkillers like paracetamol or mefenemic acid relieves the pain up to great extent. Hormonal medications like progesterone or combined pills not only relieve the pain but helps to control the disease process. These medications are not useful in all women with endometriosis and some women are not able to tolerate the side effects that these medications have. Medications do not provide permanent cure.

Surgery - is done to remove endometriosis and the scarred tissue around it. In severe cases surgery is the best choice for treatment. Surgery is done by minimally invasive way. Laparoscopic surgery is the standard approach. On average, one in three patients who had a laparoscopy for endometriosis will require a repeat procedure within five years. Complete removal of all implants during the first surgery is therefore important. Robotic assisted laparoscopic surgery these days gives the advantage of precise and complete removal of all endometriosis with preservation of ovarian tissues for future child bearing. Extent of surgery depends on the patient’s needs. If infertility is the issue then conservative approach and trying to save the normal tissues is attempted followed by treatment for infertility by advanced reproductive technology. If the woman does not desire any more children the complete removal of uterus along with both ovaries and all endometriotic tissue is done. Sometimes a procedure called laparotomy may be needed.

 Endometriosis is a progressive disease. The source of the problem is the hormonal changes associated with periods and presence of endometrium at abnormal places. After conservative surgery the disease can recur. Patients who are treated with both surgery and medications have extended symptom-free period. 

Author: Dr.RoomaSinha