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.
[posted 11/12/1999]
Question: I have been taking the depo provera shot for several years now for endometreosis. I have recently married and was wondering if my chances of becoming pregnant are less then the average woman. If we decide to try and conceive, what other methods or treatment could I use? Also, how long after you stop taking the medication will you start to ovulate and potentially become pregnant?
Answer: Women with endometriosis tend to have more difficulty. But, the depo provera would not be expected to make that worse. As to the time of ovulation, this would theorectically be within one to two months after stopping the depo depending on your ovulation regulatity.
[posted 08/22/1999]
Question: I have just started taking Prempro for my endometriosis am about 1/2 way through the 1st month. I have started to experience bleeding which to me isn’t normal (brownish. This concerns me!
I was under the care ofa repected infertility & endocrine doctor at MUSC for my condition over the past 3 years. I was in the middle of treatments–depot lupron 11.25 mg when I wentto get a3rd shot- which ment I have already completed 6 months-when I go to the ofice to find my doctor no longer is at the hospital and I wasn’t aware. After 3 hours another OBGYN was able to look at my chart and made te call to continue with the shot but put me on “add back therapy”–Prempro. Since this is not a specialist or even anyone who knows my past history–do you think it is normal for me to be on this method of treatment. I have had 2 surgery’s one in 1992 at Duke which was exploritory to diagnos the problem and another 2 yrs ago at MUSC which they lasered the endometriosis and did something to the nerves to ease my pain.
I guess my main concern now is that I have no had any bleeding for 7 months and now I do?
Thanks for any help you can give. I travel with myjob s I’ll difficult to make an appointment. Esspecialy since I don’t know what Doctor to go too anymore.
Answer: First, find out where the previous doctor went and call them for advice. Second, this would be ok therapy, but if the lupron was working why? The prempro clearly is sloughing the lining of the uterus and realistically, this should be done once or twice a year. So, I’m not opposed to the treatment but they should be handling you as a person and not as a chart.
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!
Answer: Fairly common problem. But, most women don’t have major
problems with fertility. As to the surgery, you’ll need to see your doctor to determine
this. Sounds like yours is pretty bad or you wouldn’t need surgery.
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.