You doctor gives you the results of your laparoscopy. He/she shows you the picture of your uterus, ovaries, cul de-sac, all splotched up with red, pink, purple-ly looking blobs of jelly looking gunk. He grabs another shot; there are some cobwebby things strung all over your pelvis and they remind you of left over Halloween decorations. What is this stuff invading your insides, you ask? Then he says it: Endometriosis.
“I have endometriosis,” you say. But what does this mean? What do you do now?
Endometriosis is the presence of endometrial tissue, tissue that is normally shed during menstruation, growing outside of the uterus. The most common locations for endometriosis to grow are the Fallopian tube, the outer surface of the uterus, the cul-de-sac, the tubes, the ovaries, and the intestines. It is not uncommon for women with intestinal endometrial implants to experience bleeding with bowel movements that coincide with their endometriosis symptoms. The fact is, endometriosis can be found anywhere in the body. Less common places outside the pelvic cavitiy for endometriosis to grow are the liver and old surgical scar, the brain, and even the lung. These instances are very rare, but it has been reported. Cerebellar Endometriosis
So, what do you do now? What are your treatment options?
Your surgeon most likely removed all visible traces of endometriosis during your operation. Whether your endometriosis was excised or burned off with lasers, it will return in time. Endometriosis is a chronic condition with no known cure. Treatments and surgeries only work to mask the symptoms or hinder the growth of the disease.
Unless you suffer from intense migraines, have had estrogen receptive cancer or a blood clotting disorder, or wish to get pregnant, your doctor is likely to offer a combined hormonal birth control option. This may be in the form of the pill, patch, or ring. All of them have their pluses and negatives. Some people may experience side effects while some may not. Only you know if this option is a viable one for you.
If you choose to go with the pill, you now have the option of taking the 28-day packs and having a menstrual period, or taking one of the newer pills that are taken for a continuous 3 months before having a menstrual period. The patches are convenient and can be worn for three weeks and taken off during the week of your period. But they have a limitation – you have to be under a certain weight for them to fully effective. The ring is also a convenient form a hormonal birth control that doctor’s say helps with endometriosis. It’s easy to use and the only possible downside could be forgetting to take the ring out after the third week.
There are also progesterone only options – pills and IUDS. Ovulation is suppressed withthe pill form and there are side effects, including an increased risk for blood clots. The IUD is effective in reducing menstrual flow, or even stopping menstrual flow in some women. This can be a huge relief to women who had problems during their periods. The side effects are not often a problem with the IUD as with the pill because the progesterone is in a much lower concentration (1/7th that in the pill form), and it mostly remains within the uterine cavity.
Other hormonal treatments for endometriosis:
Danazol– a form of testosterone that reduces your level of estrogen. This places you in a psuedo-menopausal state withappropriate side effects. This comes in a pill form.
GnRH Antagonist – This medication overflows your system with a naturally occuring hormone and shuts down ovarian production. It’s side effects are similar to Danazol only milder in nature. These are given in injections or inhalation form.
Gestrinone – This medicine works much like the others in this category, yet it effects the estrogen production in the ovary. The side effects are similar to the others, as well, and is taken twice daily.
** My personal opinion, based purely on experience: I have tried several brands of birth control pills and none of them controlled my pain because they didn’t stop my bleeding. They also aggravated my migraines and made me unbearably nauseous. I tried the Seasonal brand that is taken for 3 month and experience 3 months of straight, non-stop bleeding! Not what the pills intended, at all! I also became sick with my stroke-like migraines, couldn’t eat for most of the three months, and bled all the time! My pain was non-stop! I have tried the ring which also didn’t really work, and the patch was denied to me. I have tried the Depot Provera shot and could only suffice, barely, the one injection that lasted 3 months! It was hell!! Migraines. Cramps. BLEEDING – non-stop! For three months! My experience with the MirenaIUD has been much better. I haven’t had a really period since 1 month after having it instertedin April of 2007. So, yeah, that’s two years! Withthis has gradually come less and less pain. My pain sources of pain is from recurrent benign ovarian cysts. These can sometimes get pretty big before they either burst or dissolve. This is the only draw back I have found, so far, with mirena.