Endometriosis

Uterus gone wild

Endometriosis is when the lining of the uterus goes crazy and worms its way out into the pelvic cavity. From there, it starts growing on the organs of the pelvis and wreaking havoc on a major scale. This is usually exquisitely painful for the unfortunate woman who has to deal with this condition. Throughout history, women have been told that painful periods were just “woman’s lot in life,” but it turns out that endometriosis is actually something that isn't supposed to happen. Other symptoms include infertility, constipation, diarrhea, and heavy bleeding. The most common symptom is pain, though, and it is what drives most women to any means necessary to get rid of the endometriosis – even if it means removing their uterus entirely.

Make the pain go away: pain killers in endometriosis

Since pain is the primary symptom of endometriosis, many doctors will attempt to control it by controlling the pain. Although narcotics would be nice, they are not always available. Sometimes, for extreme cases, you may need a narcotic, but most endometriosis is treated with NSAIDS, or non-steroidal anti-inflammatory drugs. This includes ibuprofen, naproxen, and ketoprophen. Since endometriosis pain is caused by a release of prostaglandins and these medications work by blocking the actions of these pain causing hormones, you would think that NSAIDS would be very effective for treating endometriosis pain. Unfortunately, the medication must be taken before the prostaglandins are released – or before there is pain. This means taking the pill before you ovulate or expect to have your period. Some even recommend taking an NSAID every day in anticipation of the pain, but this can lead to stomach ulcers. Consult with your doctor before using NSAIDS in this way.

Raging hormones: endometriosis meets the pill and others

The second line of treatment for endometriosis is the use of hormones, usually birth control pills. This can sometimes stop the pain, but it is not a cure for the condition. It does not eliminate any of the implants that have grown into the pelvic cavity, and it does not help all women. What's worse, it does not always remain effective. Progestins are also used to control endometriosis symptoms, but they are only effective in three out of four women and do not take all the symptoms away. Hormone therapy is little more than a bandage for endometriosis. It does not address the main problem: the implants of uterine lining that are growing out of control in the pelvic cavity. Only surgery does that.

In the lap of luxury: surgery for endometriosis

Endometriosis is not even definitively diagnosed without laparoscopic surgery and biopsy to prove that the condition exists. A laparoscopy is surgery conducted on the abdomen through small incisions with long, thin instruments and a lighted camera. This allows the surgeon to go in and observe endometriosis, then take a sample for testing. If endometriosis is found and confirmed, surgery is often the only way to get relief from symptoms, but even it cannot guarantee complete removal of the implants. During surgery, the surgeon can excise, or cut away, the implants that he can see in the pelvic cavity that are causing pain. If the endometriosis is extensive, this can make the surgery quite complicated and lead to pain for you afterward. A surgeon can also use coagulation, or burning away, the implants that he finds. Excision is the better technique, but it takes more time and skill on your surgeon's part. It has the least rate of regrowth. If endometriosis is extreme enough, you can opt to have a hysterectomy done, as well. This needs to be approached with caution as it takes away your fertility. However, no surgical procedure, including hysterectomy, is totally infallible. The endometriosis can still return if implants are missed or any parts of the reproductive organs are left. This means that symptoms can resume and more surgery would be necessary.

References

• Endometriosis.org; Pain Killers; Ros Wood and Ellen T. Johnson
• Endometriosis.org; The Pill; Ros Wood
• Endometriosis.org; Progestins; Ros Wood
• Endometriosis.org; Surgery; Ros Wood

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