With gynecological treatments you can choose for a hormone treatment and / or the surgical removal of the endometriosis.
Different hormones may be used including the normal combined contraceptive pill, continuously used progesterone or GnRH agonists. The choice of hormonal treatment is very dependent upon the individual situation of the patient and the potential side effects must be discussed.
- The combined contraceptive pill often makes the periods less heavy and may also prevent pain associated with sexual intercourse. Women with endometriosis are often advised to use the pill continuously in order not to have any periods (discuss this with your gynaecologist if you would rather take a week’s break).
- Continuously used progesterone can take away or reduce pain symptoms. It comes in the form of tablets (orgametril/provera) or an injection into the muscle (depoprovera). Continuous use of progesterone may cause some irregular bleeding and fluid retention.
- GnRH agonists suppress the function of the ovaries so that the patient temporarily enters the menopause. Likely side effects include menopausal symptoms: sweats, flushes, and a dry vagina. In principle such drugs cannot be used for more than 6 months as after that time they may cause irreversible thinning of the bones (osteoporosis). For those requiring longer term treatment, an oestrogen tablet may be prescribed to prevent this risk (add-back therapy).
Gynaecologists can remove endometriosis by means of a laparoscopic operation. During the operation various energy modalities may be used including electrosurgery and high-frequency ultrasound. The more radical the surgery, the more endometriosis removed by the surgeon, the less is the chance that the disease will return. There is, however, a risk of complications including damage to the bladder, bowel and ureters and some times an ovary must be removed. You need to discuss all such risks with your gynaecologist.
The (international) specialists of Endometriose in Balans have extensive experience in complex laparoscopic surgery.
Besides combatting pain and other symptoms and learning to live with endometriosis our centre offers a complete range of expert help. Alongside our specialist gynaecologists, we also have the following specialists in house:
- Colorectal and thoracic surgery
- Pain specialists
- Physiotherapist specialising in pelvic conditions
- Clinical psychologist specialising in endometriosis
- If, during your clinical assessment, it seems that you may require psychological support, it may be discussed with you in order that you may may make an appointment with our psychologist.