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Endometriosis Treatment

A painful condition known as endometriosis occurs when tissue that resembles the lining of the uterus develops outside of it. The misplaced endometrial tissue reacts to the hormonal fluctuations of the menstrual cycle, just like the cells lining the uterus would do.

We at Ellicott Acupuncture Centre understand that during menstruation, the endometrial cells that have grown outside the uterus cannot exit the body, causing internal inflammation, scar tissue, and bonding to form. Repeated inflammation can lead to severe pain, infertility, bowel and bladder problems, and other complications.

When endometriosis is diagnosed, treatment is usually recommended to reduce symptoms and control disease progression. Endometriosis treatment aims to reduce or stop the growth and process of endometrial tissue outside the uterus.

Treatment goals are to minimize pain, restore natural function, and improve quality of life. Treatment options vary based on a woman’s symptoms, disease severity, age, family planning goals, and other health factors. Treatment may involve lifestyle changes, pain medication, hormonal therapy, surgery, or a combination approach.

Reasons for Endometriosis Treatment

There are several important reasons why women with endometriosis often pursue treatment. The most common motivations involve managing pain symptoms and improving fertility potential. 

Pain Relief 

The hallmark symptom of endometriosis is pain—sometimes severe pain. Pain is usually felt during periods (dysmenorrhea) but may also occur with intercourse, bowel movements, or at random times between periods. As endometrial tissue grows at multiple ectopic implantation sites, it can cause internal inflammation, adhesions, and scarring that compresses and distorts nearby organs, leading to pain. 

At more advanced disease stages, the pain tends to worsen with a greater extent of disease. Untreated endometriosis pain can seriously impair a woman’s quality of life through her inability to work, attend school, or participate in daily activities. Effective pain relief is usually a primary motivation to pursue endometriosis treatment. Managing symptoms helps women function better during their daily routines and periods.

Top Treatments for Endometriosis

Fertility Concerns 

Adhesions, scar tissue, and distortion of the pelvic anatomy caused by advanced endometriosis can damage the fallopian tubes and ovaries, sometimes leading to infertility.

Do you know?  

  • Studies show that up to 50% of women with the most severe form of endometriosis, called stage IV, have difficulty getting pregnant.

While endometriosis does not always cause fertility issues, the risk is significantly higher than in women without the condition. 

For women desiring pregnancy, restoring natural fertility is a primary goal of treatment. By stopping the growth and spread of endometrial lesions, specific endometriosis treatments aim to reverse the damage and improve fertility potential. When surgery is performed, gynecologists can detect and remove endometrial growths that obstruct fallopian tubes or damage ovaries.

Best Endometriosis Treatment

Disease Progression Prevention  

Left untreated, endometriosis tends to gradually worsen over time as more areas of the body become infiltrated by endometrial cells. Repeated cycles of retrograde menstruation allow additional foci of endometrial growth. Unopposed estrogen stimulation also promotes lesion growth and adhesion formation. 

Advanced stages of endometriosis bring higher risks of developing complications like bowel or bladder endometriosis, deeper pelvic scarring, and abnormal organ fixation. Treatment aims to prevent disease progression by suppressing hormonal stimulation and prohibiting further cell attachment, proliferation, and spread. The halt of progression preserves organ function and limits future complications. 

Overall Health Concerns 

Beyond fertility and pelvic pain issues, endometriosis has associations with several other chronic health problems that long-term treatment may help reduce risks for: 

  • Autoimmune disorders like lupus and rheumatoid arthritis. Suppressing inflammation may lower autoimmune disease potential. 
  • Mood disorders, including anxiety and depression, are linked to pain and quality-of-life impairments. Relieving symptoms improves mental well-being
  • Fatigue and functional impairment are due to both physical pain and emotional distress symptoms. Treatment enables higher activity levels. 
  • Ischemic heart disease is believed to be linked to higher long-term estrogen exposure in endometriosis. Suppressing estrogen signaling may confer some cardiovascular protection over the lifespan.

Endometriosis Treatment Options 

Various medical and surgical options exist for endometriosis treatment, depending on the circumstances. Treatments are aimed at the core pathogenic mechanisms driving the disorder. 

Lifestyle Changes 

Making dietary modifications and incorporating stress management techniques can help some women minimize endometriosis symptoms naturally. Some recommendations include: 

  • Eating an anti-inflammatory diet rich in omega-3 fatty acids and antioxidants; maintaining a healthy body weight
  • Limiting caffeine and alcohol intake 
  • Getting regular exercise 
  • Practicing deep breathing, yoga, or meditation for relaxation 

Pain Medication 

Over-the-counter options like ibuprofen and naproxen can provide relief from mild to moderate endometriosis pain during menstruation. For more significant pain, prescription NSAIDs, narcotics, or lidocaine patches may be used. Nerve block injections or neuromodulation techniques involving implanted devices are being explored. 

Hormonal Suppression 

Hormonal birth control pills, patches, rings, injections, or IUDs containing progestins or a combination of estrogen and progestin work to regulate menstruation and thin the uterine lining. This decreases retrograde bleeding and limits the tissue’s response to estrogen in growth outside the uterus. Common options include: 

  • Combination oral contraceptives (COCs) 
  • Progestin-only pills, implants, or injections (Depo-Provera) 
  • Levonorgestrel intrauterine device (LNG IUD/Mirena) 
  • Gonadotropin-releasing hormone agonists (GnRH agonists like Lupron) 

These hormonal treatments may provide significant pain relief and suppress disease progression in many cases. Side effects can include irregular bleeding, mood changes, and possible bone loss with extended use of GnRH agonists. 

Surgery 

For deeply infiltrating or extensive endometriosis, surgery becomes necessary for a definitive diagnosis via laparoscopy and often to excise visible disease sites from organs. Procedures include: 

  • Diagnostic laparoscopy 
  • Laparoscopic excision of endometriotic lesions 
  • Cyst or ovarian endometrioma removal 
  • Hysterectomy (for severe cases or those who have finished childbearing) 
  • Colorectal or bladder resection (rarely needed) 

The completeness of the excision correlates to pain relief outcomes, so an expert endometriosis surgeon experienced in careful lesion removal is essential. Recurrence risks remain unless hormonal therapy or another treatment option is instituted post-op. 

Combination Therapies 

A combined medical and surgical approach is often most effective at significantly reducing endometriosis symptoms.

  • Surgery is performed to clear areas, followed by longer-term hormonal suppression to prevent further growth and adhesion formation. 
  • Hormonal therapy first shrinks lesions, followed by surgery to remove the smaller remaining lesions precisely. 
  • Lifestyle modifications are paired with either hormones or a single laparoscopic procedure. 

Serial laparoscopies over several years may also be needed in some advanced cases. Close monitoring, treatment adjustments, and multidisciplinary care optimize outcomes.

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