Treatment options for Endometriosis There are general points which should be taken into consideration
The severity of the symptoms
The type of symptoms
The age of the patient
The desire to get pregnant or not
Length of treatment
Coping with side-effects of drug treatment
Observation with no medical intervention
Drugs Commonly used
inhibit the secretion of gonadotropin a complete block of egg development, estrogen production and menstrual cycle, makes 'menopausal'
is a mild form of the male hormone testosterone inhibits leuteinizing hormone (LH) and follicle-stimulating hormone (FSH)
It works in much the same way as danazol with similar, but milder, side effects
suppress LH and FSH and prevent ovulation
Progesterone hormone tablets
The Mirena Coil (IUD with Levonorgestrel )
Gonadotropin-releasing hormone agonist
leuprolide (Lupron, Eligard)
buserelin ( Suprefact , Suprecor)
goserelin ( Zoladex )
deslorelin (Suprelorin, Ovuplant)
Cetrorelix (Cetrotide), by Serono
Ganirelix (Antagon), by Organon International
Definitive surgery, which includes hysterectomy and oophorectomy, is reserved for use in women with intractable pain who no longer desire pregnancy.
In less severe cases, one ovary may be retained to preserve ovarian function
Surgical Treatment Laparoscopic excision of nodular endometrial lesions overlying the rectum Nodular endometrial lesions in the posterior cul-de-sac.
Surgical vs. Medical Treatment of Endometriosis Effective for pain relief Unlikely to improve fertility Empiric treatment Adverse effects common Decreased initial cost Medical Option for definitive treatment Definitive diagnosis Invasive Possibly better long-term results Expensive Beneficial for infertility Surgical Disadvantages Advantages Treatment
Adverse effects common
Unlikely to improve fertility
Decreased initial cost
Effective for pain relief
Beneficial for infertility
Possibly better long-term results
Option for definitive treatment
Surgical Disadvantages A dvantages Treatment
a laparoscopically defined cumulative five-year recurrence rate of about 19 percent.
t he long-term benefit of surgical intervention for pain is enhanced by definitive surgery, including bilateral oophorectomy, with a 10 percent cumulative recurrence after 10 years.
surgical treatment is the apparently lower recurrence rate compared with medical treatment