A common problem affecting approximately 10% of the population, it can be debilitating in its effects for some women. Only found in women in their reproductive age group, it presents with symptoms of
All women so affected deserve time spent in explaining this difficult condition to them. By making them aware of the extent of their condition and the ramifications it holds for them goes a long way to reduce their fears.
Diagnosis can only be made by visualising the areas of endometriosis at the time of laparoscopy. Ultrasound can only indicate the possibility of this, but is not good enough to confirm the diagnosis.
Menopause is the only cure for endometriosis. Many cases develop at much younger ages, and so menopause is not the solution for them. Other treatment have evolved to control their endometriosis and relief from symptoms. The two main methods involve
- Hormonal medications
- Surgical resection of endometriosis.
Hormonal treatment varies from the use of the Pill throught to GnRh agonist therapy with the latter causing a pseudomenopause for 6 months. Recently a new progesterone treatment called Vissane was released for this purpose. The use of a progesterone IUD called Mirena has also been helpful for some cases.
Should surgery be required then usually I use minimally invasive surgical techniques to achieve this. The aim is to remove the endometriosis. In some cases, the decision may be made to perform a hysterectomy and perhaps removal of the ovaries as well.
The combination and type of treatment will depend on the age of the woman, her desire for fertility and severity of symptoms. These are the issues that I discuss with my patients, as endometriosis is clearly a condition that needs close understanding of her needs, in order to obtain the best outcome.