Endometriosis Treament

No comments:


Please note, I am not a healthcare professional. I'm just someone who lives with endometriosis, and the information I'm sharing here comes from my experience, from knowledge that has been shared with me by healthcare professionals, and also from studies, articles, films, and podcasts that I've come across. This shouldn’t be taken as medical advice. Please consult your doctor before beginning new treatments or making lifestyle changes.


Treatment Options for Endometriosis 

There are some common options when it comes to treating endometriosis. And your gynaecologist should discuss all options with you; your treatment should be decided in partnership between you and your gynaecologist. It's important to bear in mind that treatments are there to reduce the severity of symptoms, but they won't eliminate the symptoms completely, as there is currently no cure for this condition.


Surgery

Surgical treament of endometriosis is carried out during a Laparoscopy.

There are now various different options in terms of surgery to treat endometriosis, including the following ~ please note most of the following info is taken from the Endometriosis UK factsheet on laparoscopies for endometriosis. It may be helpful to read through the factsheet:

Endometrial ablation
This is when the womb lining is removed or destroyed using a variety of methods including lasers, electric currents, being frozen or using heat. This is a treatment for heavy menstrual bleeding and can permanently stop periods and prevent future childbearing. 

Electrocoagulation/Diathermy
This is the use of electrical heat as used in general surgery. It can be used to destroy and remove endometriosis, as well as control bleeding.

Excision Surgery
This involves actually cutting out areas of endometriosis using either scissors or lasers. This is known as the best way to treat endometriosis.

Helica Thermal Coagulator
This uses Helium gas and a small electric current to dry out endometriosis using a process called fulguration.

Harmonic Scalpel/CUSA (cavitron ultrasonic surgical aspirator)
These are devices with a vibration tip and can be used in the treatment of endometriosis.

It is important to be aware that not all of the above mentioned techniques are available at all hospitals. Do discuss your options and preferred method with your surgeon beforehand. However, bear in mind that you may not be able to choose the type of surgery carried out, as this depends on the surgeon's experience, training, equiment and your disease.

If endometriosis is found during a laparoscopy, surgeons should have the skills to treat the disease so that they can go ahead and treat it during surgery; ideally they should cut out the endometriosis - this is known as an excision (mentioned above). The surgeon must completely excise the lesions, not just burn the "tip of the iceberg" (Endo What? film). Which is what I had done in my first laparoscopy.

However, "The vast majority of surgeons use lasers to burn the surface of endometriosis, rather than cut it out" (Endo What? film). It is better to not burn/cauterise/laser the endometriosis away (although this is needed in some rare cases). "When you remove or destroy using energy, you leave a burn tissue behind. That burn tissue at times still has residual endometriosis on it" (Endo What? film). Plus, often the endometriosis is deeper in the underlying tissues than the energy penetrates. Either way, "the fibrotic scar tissue left behind is the soul of endometriosis itself", as it can form adhesions. Therefore, burning/cauterising/lasering does not effectively treat the disease.

Excision of endometriosis ~ cutting it out rather than just burning the surface ~ is considered the best treatment on offer. It has been reported that 60% of women have improvements in symptoms/pain scores after excision of endometriosis. This is across all types and severity of endometriosis.

Surgery can provide some relief from symptoms, but endometriosis can continue to grow. It surgeons have treated your endometriosis by burning it, then it is likely you will need to have this surgery done again. "Even after surgery, you still have the disease and you've got to know the disease well, you've got to know your own enemy in order to manage it" (Endo What? film).

I've also found out that some doctors may suggest operation to remove part or all of the organs affected by endometriosis - such as surgery to remove the uterus (hysterectomy) or surgery to remove the ovaries (oopherectomy). This may be needed in some rare cases, but please do thoroughly research, consider and discuss your options with your gynaecologist and surgeons, as in reality a hysterectomy or similar is a permanent change to your body and does not cure or eliminate endometriosis.

There is also a theory that pregnancy cures endometriosis, some people have reported an improvement after pregnancy but this is not guaranteed, so having a child because of your endometriosis is a very bad idea. Even if your doctor suggests it!

Some questions you can ask your surgeon(s): What exactly will happen during my surgery? What are the outcomes? What are the possible complications/risks? What are the complication rates? Do they work collaboratevly with other specialists when doing this surgery?


Hormone Treatment

As mentioned in "What is Endometriosis?", it is believed that endometriosis responds negatively and grows when exposed to the female hormone oestrogen, and that people with endometriosis have a hormonal imbalance, mainly oestrogen dominance.

Hormone treatments attempt to reduce the growth of endometriosis by blocking or reducing the production of oestrogen in the body. The following hormone treatment options are available to women with endometriosis:
  • Combined oral contraceptive pill (‘the Pill’) ~ this is the treatment I'm currently trying* 
  • Mirena Coil ~ I've tried this in the past* 
  • Progestogens ~ usually in the form of progesterone only pills or 'the mini pill' 
  • GnRH analogues 
  • Testosterone derivatives 
  • Danazol 
  • Gestrinone (Dimetriose) 

If hormone treatment is an option for you, it is important to research, ask questions and discuss it thoroughly with your gynaecologist, as the potential side effects with this form of treatment can be severe. You really need to understand the Pros and the Cons.

*I've written all about my journey with endometriosis, including treatments I have tried and treatments I am trying ~ 'Endometriosis: My story & what has helped me'.


Pain Relief

Other treatments are there to help with pain relief, this includes pain-killers and anti-inflammatories such as Ibuprofen, Paracetamol, Mefenamic Acid (Ponstan), Codeine, Tramadol, Voltarol.

I'm currently trying Magnesium Spray and so far, it's been helpful in reducing pain. CBD oils have been recommended to me as an endo pain relief option too, but I've not yet tried this myself. This EndoLife wrote a great blog post about natural pain relief where she talks about Magnesium Spray and CBD Oil ~ My Top Five Natural Remedies for Endometriosis Pain Relief.
Using heat in the form of a hot water bottle or taking a hot bath can also help with pain relief. Some people find wheat bags to be effective. Personally, I've found that Castor Oil Transdermal Packs treatment, can be quite helpful with pain relief.

The endometriosis diet has also proved effective for some, me included. In addition, comfort, healthy diet, rest and reduction of stress (as much as possible) can also really help with endometriosis pain. Reducing stress helps as "the body produces stress hormones - cortisol. And when the cortisol rises it also increases the cytokines - which is an inflammatory protein that causes inflammation. So, stress has a direct correlation to inflammation" (Endo What film). I talk more about this in the 'Endometriosis Diet' and '10 Lifestyle changes that help me manage my Endometriosis' posts.


Tranexamic Acid

I've also found Tranexamic Acid very helpful when it comes to managing the heavy bleeding; I used to get very stressed with the constant heavy bleed, managing this has helped me feel more comfortable, thus helping with pain management too.

This is not a pain-killer or a contraceptive. These tablets work by slowing the breakdown of blood clots, as a result it helps to reduce bleeding.

No comments:

Post a Comment

Thank you for your comment x

Copyright 2018. All Rights Reserved. Unapologetically Elly ©