Endometriosis is a common condition associated with chronic pelvic pain, infertility, scarring of the pelvic organs and chocolate cysts or endometriomas. The condition typically causes pain before and during periods and also painful sex. It can only be diagnosed with a laparoscopy (keyhole surgery) although it may be suspected from symptoms and sometimes on an ultrasound if an endometriotic cyst is identified.
Olivia will offer you investigations and offer treatment for endometriosis when it’s suspected or diagnosed. Treatment for endometriosis is either using medication and / or surgery or a combination of both:
Painkillers – such as anti-inflammatories (e.g. Ibuprofen, Naproxen), Paracetamol and/or opiates (e.g. Codeine, Tramadol, Nefopam)
Hormones
Combined oral contraceptives – often taken without the break
Progesterones – Cerazette {Desogestrel} (one type of minipill), Depoprovera injections, Nexplanon (implant), Mirena IUS (hormone coil) {all off-license uses but can be effective}
GnRH analogues (usually with add-back HRT {Hormone replacement therapy}):injections to cause a temporary menopause and allow the endometriosis to subside and heal. This is a highly effective but potent treatment.
Treatment for IBS – Most women that have endometriosis also have Irritable Bowel Syndrome so it is important to treat this as well as the endometriosis.
Surgery may involve laparoscopic cauterisation or excision (cutting out) of the endometriosis or removal of cysts and scar tissue and sometimes as a last resort removal of the womb, tubes and ovaries (hysterectomy). It is important to remove the ovaries to help prevent recurrence of the endometriosis at a later date. If you have your ovaries removed it is important to use HRT (hormone replacement therapy) at least up to the age of natural menopause or longer.