Endometriosis: What can be done?

HELLO once again, I hope you all had a great week. I also hope you are a little more acquainted with the idea of endometriosis and its characteristics. A lot of people ask me if anything can be done? The answer is yes. However, it doesn’t always work out as some ladies respond very well to treatment while others do not.

The first treatment to be suggested to me was going on contraception, which is commonly used to reduce the heavy flow and to try and normalise erratic periods. I was 17 at the time so my parents were highly against it.

After seeing the continual agony I was in, they gave in and I started on depo-vera injections. This falls under the hormone therapy section of endometriosis treatment. This is a progestin-only contraceptive. Another one like this is the Mirena coil.

The purpose of these is to halt menstrual periods and consequently the rate of growth of the endometriosis lesions. This can relieve pain and bleeding. Hormone patches can also help to reduce or eliminate pain in some women.

Under hormone therapy there are also Gn-RH (Gonadotropin-releasing hormone) agonists and antagonists. These drugs halt the development of ovarian stimulating hormones and they reduce the estrogen levels in the body. The purpose of this is to cause the endometrial lesions to shrink.

These treatments do come with side effects such as getting hot flashes, vaginal dryness and bone loss. When a woman is on such a treatment she basically goes through “temporary menopause”. Drugs like these go under names like zoladex or lupron. It is important to know that zoladex/lupron are drugs created for breast and prostate cancer and come with some nasty side effects and sometimes make you sicker than you were in the first place. I have personally declined this route.

Another drug that is especially made for endometriosis is visanne. It also aims to shrink endometriosis.

Lastly, in the hormone therapy section, there is danazol. Danazol suppresses the ovarian stimulating hormones. One of the side effects is that a woman can endure on danazol is growing a beard or developing a deeper voice. Danazol contains a testosterone element to it.

Surgery is another option for treatment of endometriosis. This is also the one and sure way to diagnose endometriosis. It is called a laparascopy. In a laparascopic surgery, a surgeon inserts a viewing instrument or camera (laparascope). The surgeon makes small incisions for this, one for the viewing instrument and the other for removal of the endometrial tissue.

I have had two surgeries and apart from being painful it can be scary. Some women have undergone more than 10 surgeries. This is simply because they had no relief from previous surgeries or the endometriosis just resurfaced.

In my opinion, it is because they have not come across a skilled-enough surgeon. Some gynaecologists can treat it but the best person to do an endometriosis surgery is an endometriosis specialist. Here in Zimbabwe we have one. These endometriosis specialists do hundreds of endo surgeries each year and can tell the different colours and characteristics which some gynaecologist can miss.

It is also important to know that excision surgery is the best type of surgery to tackle the symptoms of endometriosis. Excision removes endometrial implants by cutting them away from the surrounding tissue.

One of the other things that doctors say can “treat” endometriosis is a hysterectomy (termination of womb). This is not true. Doctors also say that pregnancy is a “cure or “treatment” for endometriosis. That again is not true. Several times that I have seen doctors or been rushed to an emergency room, I’ve been told “you should just have a baby! Then all your issues will go away”. This again is not true.

Some women have felt some relief after having a child but in many cases the pain comes right back and they find themselves struggling again. Moreover, they struggle even more because they have another little person to take care of.

In severe cases of endometriosis where a woman is bleeding constantly and cannot manage the pain, a doctor will suggest a hysterectomy. Again in some instances women do get relief but in many cases, women regret destroying their chances of conceiving and still having the pain.

Apart from the physical pain of recovering from a hysterectomy, there is emotional pain and hormonal instability because a woman is forced to go through menopause well before she is ready.

Managing endometriosis is extremely complex and women try so many different things to find some relief. I am not very big on having just any surgeon open me up hence having only two surgeries but I have tried most of these treatments and haven’t experienced much change.

It really depends on the person and the stage of the disease as well. The important thing is to try and never give up. I believe there is hope. I have said a mouthful I know, so I will plunge into remedies next week instead. Stay safe. Ta!