In this condition factsheet:
A doctor will begin by taking a medical history and conducting a pelvic exam. Your doctor will ask about symptoms associated with endometriosis. During the pelvic exam, he or she will check internally for lumps and bumps. This may be followed by an ultrasound of the pelvis to look for cysts on the ovary. Often, the ultrasound may fail to show anything.
If the history and pelvic exam suggest endometriosis, the next step may involve a procedure called laparoscopy. With this procedure, a tiny cut is made near the navel and a thin tube inserted. This tube (the laparoscope) is an illuminated microscope that enables the doctor to clearly see the endometriosis on the outer surfaces of the pelvic organs. The doctor may take a tissue sample during a laparoscopy and a pathologist examines the tissue sample to confirm if endometriosis was found. Laparoscopy can also be used to treat endometriosis, using a laser or electricity to burn off the endometrial tissue.
Treating and Preventing Endometriosis
Endometriosis may be treated with medication, laparoscopic surgery, or traditional surgery. The choice of treatment depends on the individual, and is affected by a number of factors, including the woman's age, the severity of her symptoms, and her plans for pregnancy.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen* and ibuprofen, can be used to relieve pain. However, they do not treat the underlying cause of the condition. The contraceptive pill is also used in the treatment of endometriosis. Instead of taking the contraceptive for 3 weeks followed by 1 week off, it is taken every day. For most women, this eventually causes menstrual bleeding to stop. Medroxyprogesterone may also be used to treat endometriosis. Usually, it is given as an injection. Endometriosis can also be treated with medications that regulate the menstrual cycle, stopping a woman's period and mimicking menopause. These medications include danazol, buserelin, goserelin, leuprolide, nafarelin, and triptorelin.
Laparoscopy and minor surgery can be used to remove endometrial tissue from places where it should not occur, such as the pelvis. During laparoscopy, the doctor will use electricity or a laser to burn off endometrial tissue. Laparoscopy is a less invasive procedure than traditional surgery (e.g., hysterectomy), and can be done on an outpatient basis (without the person being admitted to hospital). Larger and more embedded growths may require traditional surgery.
Women who do not wish to later become pregnant may opt for a total hysterectomy and oopherectomy (removal of the uterus, ovaries, and fallopian tubes). Combined with medication, this procedure eliminates the body's production of female hormones thereby relieving the symptoms of endometriosis. However, there is no guarantee of pain relief. Loss of both ovaries results in estrogen deficiency. Women who undergo this procedure will be offered hormone replacement therapy. Before starting hormone replacement therapy, discuss the risks and benefits of this treatment with your doctor.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.References