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Endometriosis: Help is available

» Hormonal therapy

» Surgical approaches

Is pregnancy an option?

If you have endometriosis, you may be concerned about your ability to conceive. Extensive scarring around the reproductive organs essentially “freezes” the ovaries, the fallopian tubes and the uterus. Eggs may remain “stuck” in the ovaries or be unable to make their way through swollen tubes.

In mild stages of endometriosis, women can still get pregnant without any treatment. As the disease progresses, women who want to start a family will most likely need surgery. When discussing treatment plans with your healthcare provider make sure you discuss your childbearing plans.

Could you have endometriosis?

If you have any of these symptoms, see your healthcare provider:

  • painful periods with heavy or irregular flow
  • lower back pain
  • chronic pelvic pain
  • painful bowel movements during periods
  • painful intercourse
  • long-standing infertility
  • tenderness of the abdomen

Here’s good news for the 5 percent to 10 percent of women who have endometriosis: Effective treatment and relief are available. Endometriosis occurs when tissue from the uterus escapes and implants on other organs in the body, causing painful periods, debilitating cramps and fertility problems. But several treatment options can help a woman overcome the discomfort and restore fertility. If you have endometriosis, your healthcare provider can help develop a treatment plan that’s right for you.

Hormonal therapy

Because endometriosis is aggravated by your menstrual cycle, treatment involves producing a pseudomenopausal or pseudopregnancy state. Hormonal therapies work by controlling the amount of estrogen your body makes, thereby decreasing the amount of endometrial tissue produced and lessening the chances of stray tissue. The treatments are administered through nasal sprays, injections or pills. Below are some widely used therapies.

  • Danazol is a synthetic steroid that shrinks endometrial tissue, eliminating implants. Its side effects include a possible permanent voice change, high cholesterol, dizziness and weight gain.
  • Gonadotropin-releasing hormone (GnRH) agonists prevent the release of estrogen. Side effects are much less severe compared with danazol.
  • Progesterone treatments enhance the shedding of endometrial tissue. Side effects are mild.

Before beginning treatment, discuss possible side effects with your healthcare provider and make sure you understand them thoroughly.

Although hormonal therapies are effective while they are being administered, they can only be taken for a few months. Unfortunately, symptoms often return at some point after the treatment ends. New medications are being studied that may provide permanent relief. Until then, hormonal therapy is often accompanied by surgery.

Surgical approaches

In some situations, surgery is the most practical option. When endometriosis is mild and confined to the uterine area, a laparoscopy may be performed. In this procedure, diagnosis and treatment may be possible in the same session. The surgeon inserts a scope through a small incision near your navel and uses fiber-optic lights to examine the uterus. Once excess tissue is located, it is removed or destroyed using a laser, cautery or other small surgical instrument. The procedure can be completed in less than a day, and recovery is swift.

When endometriosis has spread to other organs, a laparotomy may be necessary. This traditional operation requires opening the abdominal cavity to remove the tissue and a two- to four-day hospital stay. Recovery is slower and more painful and may last four to six weeks.

In rare cases when hormonal and surgical treatments don’t bring relief, a complete or partial hysterectomy may be required.


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