How should I treat endometriosis?

The answer to that question is totally dependent upon what your goals are. Initially, pain control is most important. Reductions in pain can sometimes be obtained by simply taking noncylic low dose birth control pills. (Skip the inactive last seven pills and have no periods). Endometriosis can be suspected clinically, but can only be diagnosed with laparoscopy. Endometriosis can also be treated laparoscopically by destroying visible endometriosis with electrical energy (heat), excision, or by laser. Pain is often reduced but microscopic endometriosis is not treated. Endometriosis needs estrogen to grow and remain active. There are hormone treatments which will induce a month by month menopause. With low estrogen levels you will have hot flashes, but the pain should resolve. Lupron is the most commonly used medication. Unfortunately many women with endometriosis will have recurring pain with the above mentioned conservative treatments. These treatments may be repeated, and may be effective each time. Eventually, when your family is complete and if pain has returned, many women resort to hysterectomy, probably with removal of the ovaries. That is a dramatic step, but does in most all cases end the pain from endometriosis. Hormone replacement is possible and it is uncommon to have recurrences on reasonable doses of hormone replacement. There is hope. You can be free from pain. Unfortunately, until the final definitive treatment, it is also likely to be a recurring problem. It is for that reason that I say that endometriosis treatment should be goal oriented, depending upon where you are in your life. It's not OK to have a hysterectomy when you want to have children. It may never be OK with you to have hysterectomy and lose your ovaries. These are the topics you need to take the time to explore with your gynecologist. Don't accept only one proposal of treatment without considering your other options.

Patient Education

What's with the NEW Pap Smear Guidelines?

With the advancement of DNA technology, it has been determined that 99% of cervical cancers are caused by Human Papilloma Virus (HPV). There are many subtypes of HPV, and a small number have been detected in cervical cancers. These subtypes are called  high risk HPV subltypes. The highest risk types are types 16... Read More

Mirena IUD

Mirena IUD's are plastic devices that fit inside your uterus and provide contraception. They have several advantages. First they are very effective with greater than 99% prevention of pregnancy.  The stem of the Mirena contains levonorgestrel, a part of many popular birth control pills. Second, once inserted, they are almost... Read More

American College of ObGYN Patient Information Website

The American College of ObGYN (ACOG) is the governing body for ObGYN doctors in America. They have created a very informative and helpful patient information page that covers a wide variety of topics for patients. If you have any questions about women's health, this website is a great resource. If... Read More

Essure Tubal Sterilization

There has been a good bit of advertising recently about the Essure method of tubal sterilization. Essure is not new, and has been on the market for a number of years. The Essure method of sterilization  requires placement of a device in each tubal opening, where it opens into the... Read More

Influenza

Pregnant women are more likely to get seriously ill from the flu. Get your flu shot.   You should get vaccinated as soon as you finish the first trimester. (12 weeks). You will not get the flu from a flu shot. Any side effects you get are generally limited to soreness... Read More

Abnormal Pap Smear - Now What?

Many women will have an abnormal pap smear result at some point in their life. If you have had an abnormal pap smear, you will generally need to have a follow up pap smear within 6 months.  Potential results of a follow up pap smear are: - Your follow up pap smear... Read More

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