Doctors' Answers to "Frequently Asked Questions" - Endometriosis

Related Women's Issues

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Endometriosis [posted 12/04/98]
Question: I was wondering how many women have it, and what are my chances of ever getting pregnant. I had the laporoscopy and ever since my cramps are worse, to the point of throwing up every morning of my period. I don't know what's wrong. I'm going for a checkup soon, but I am scared that they will tell me I have to have surgery again. What are the chances of that since I only had the surgery 4 months ago? Thanks!

Endometriosis / LLQ Pain
Question: For over 13 years, I have had to take birth control pills to control irregular bleeding. For the past 3 years I have had severe LLQ pain that has become both frequent and intense. My menstrual periods have always been irregular, and very heavy. I pass clots the size of half dollars on a regular basis during my period. I have been put through a barium enema, a sigmoidoscope, and a pelvic sonogram. All were normal. My doctor referred me to a surgeon who checked me for hernias, and said that there is no doubt in his mind that I have endometriosis. My gynecologist disagrees. My mother, her two sisters, my grandmother, and her sisters have all had some form of cancer or dysplasia in that region, and have all gone through hysterectomies by age 30. I have had dysplasia myself twice. Should I continue to play this game? I'm only 26 and would like to someday have kids. This pain is killing me and my activities I like to enjoy. The surgeon referred me for a diagnostic laparoscopy.

Answer: Certainly sounds like endometriosis. Most ob/gyn would have done a laparoscope by now and not bothered with the sigmoid, etc. I'd get the laproscope and probably a new ob/gyn. Don't get a hysterectomy yet. There are treatments for this and there is no relationship between dysplasia, cervical cancer and endometriosis. Cancer, etc., by the way is usually painless until spread widely through the body, but this is not your problem.

Endometriosis
Question: Last year I was diagnosed with endometriosis and after several laporoscopies my doctor thought that I should try Lupron (since nothing else was working). I took my last injection in January, and it would seem that my menstrual cycles are somewhat back to normal. I just recently turned 25 and I am married and would very much like to have children. However, at this point in my life, I don't feel that the timing is right. I've suffered two miscarriages to date and my doctor told me that it may be hard to get pregnant, let alone carry the child to term. He also said that the endometriosis would be with me until menopause and that it would get progressively worse with time. I would have to agree since I am getting to point where walking is even painful let alone intercourse. He prescribed Buscopan 10mg @ 3X/day. He also said that the first 6 months after taking the Lupron injections would be the best time to try and get pregnant. It was either this or a hysterectomy. Well, at 25 years old, that isn't even an option. In short, between recurrent ovarian cysts and endometriosis and the horrifying pain (which is getting worse), what actions should I take? I should also mention that the birth control pill and the various other forms of controlling it have been unsuccessful.

Answer: When women are trying to get pregnant with severe endometriosis the best time is usually after the suppression(just after stopping the lupron). Did your GYN say why you had the miscarriages? In short, I'd suppress the endometriosis 6-7 months at a time and then try and get pregnant. While you are suppressing the endometriosis, focus on the cause of the miscarriages. For example, you could have an abnormal chromosome array that could be a continuing cause. You might want to consider other options. Don't get a hysterectomy.

Endometrium
Question: What is an endometrium?

Answer: Endometrium is the lining of the uterus. It is a different cell type than the actual uterus, usually being columnar epithelium.

Natural Alternatives
Question: I have a friend (age 30) that has endometrosis. I am associated with a health and nutritional company called Higher Ideals. I would like to know if there are any natural products that I could recommend to her to help with this problem and maybe save her from having a hysterectomy.

Answer: Theoretically, some products which are advertised as "natural estrogen products" might help. In practice, I am not aware that any non-prescription treatment is helpful. Endometriosis occurs when the lining of the uterus called the endometriummigrates through the fallopian tubes and comes to rest on the abdominal organs and linings. These implants will slowly grow and cause pain and occasionally bleeding. The only treatment is suppression with birth control pills, or in the absence of improvement complete estrogen withdrawal by a hysterectomy and usually ovarian removal as well.



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