Endometriosis refers to a disorder of the endometrium layer of the uterus that occurs in females, who are commonly in the reproductive age group and in those too often seen in women in their 3rd and 4th decade of their life. Endometrium alludes to the inner-most lining of the uterus. In the case of endometriosis there is overgrowth of the endometrial tissue lining outside the uterus and usually involves the tissue in close proximity to the uterus, ovaries and fallopian tubes.
The treatment of endometriosis is symptomatic, as the cause of endometriosis rather unknown and various theories have been put forth to determine the cause.
Treatment options broadly comprises of Medical (Drug Therapy) and Surgical. There is no actual cure of the condition. The treatment involves nursing of Pain and Infertility, which are the main symptoms seen in endometriosis.
What is the Best Way to Treat Endometriosis?
Drugs for Relieving Pain
These include the following drugs:
NSAIDs – The non-steroidal anti-inflammatory drugs are used routinely to treat the pain associated with the disorder. The habitually used NSAIDs are ibuprofen, paracetamol, and naproxen. These are easily available in pharmacy stores. They have shown good effect with very less side-effects.
Hormonal Remedy to Treat Endometriosis
Oral Contraceptives Pills- OCPs have proved to be effective, their use has displayed reduced risk to encounter endometriosis. OCPs that are typically used contain both progesterone and estrogen in specific concentration.
Depot Formulations – These incorporate the injectable contraceptives which may be Progestogen – only and Combined. Progestogen – only are used commonly. These include DMPA (Depot- Medroxyprogesterone acetate), NET-EN (Norethisterone acetate) and DMPA – SC (Sub-cutaneous version of normal DMPA). They are long-acting and estrogen free.
GnRH Agonists – Analogues of Leutinizing Hormone or Gonadotropin releasing hormone are potent in relieving pain as they act upon the pituitary glands and reduce the release of FSH and LH. Goserelin and leuprolide are the examples of GnRH Agonists although their usage has been known to cause some side- effects.
Danazol – It is a synthetic steroidal drug that is androgenic in nature. It acts on the ovarian hormone synthesis and reduces its production. It also has anti-gonadotropin activity. Its side effects include – hoarseness in voice, hirsutism, nausea and vomiting. It has also shown beneficial effect in infertility caused due to endometriosis.
Surgical Treatment to Treat Endometriosis
When on medication the symptoms of endometriosis fail to resolve or are very severe in nature. Surgical procedures are then conducted by the doctor. Surgery may also be advised if there is voracious growth of the endometrial tissue. The surgical interventions conducted are mentioned below in brief.
Excision via Laparoscopy – The abnormal tissue and even scars is excised with the help of laparoscope (a visual diagnosis of the lesions if present with the help of camera passed into the abdomen). Most of the times the symptoms rectify after the procedure are conducted although recurrence is high which ranges from 35 to 40%.
Hysterectomy – It is deemed necessary when the disorder has soared with severe symptoms. Hysterectomy is basically defined as the removal of the uterus from the pelvic cavity.
Oophorectomy – In cases where increasing levels of hormones are being produced by the ovaries which lead to an increased risk of endometriosis oophorectomy is advised by the clinician.
Hysterectomy and Oophorectomy- Sometimes both Hysterectomy and Oophorectomy are indicated if both the uterus and ovaries are involved in endometriosis or in the cases of recurrence.
Barring the aforementioned medical and surgical interventions A female at risk or if diagnosed with endometriosis should also employ behavioral and lifestyle modifications like proper healthy diet involving proper supplementation of vitamin and minerals. Avoid smoking and drinking and exercise daily.
Conclusion
Endometriosis is a disorder of the inner-most lining, the endometrium which shows irregular growth. This problem does not have a specific cure, but various medical and surgical treatments are present to treat the symptoms. These include NSAID, hormonal contraceptive pills, depot formulations, and danazole in drug therapy.
Surgeries conducted are laparoscopy, hysterectomy, and oophorectomy. Along with this the woman should also bring positive change in her daily lifestyle.
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