Endometriosis Pain

by Dr. Maurice Leibman on September 11, 2010

The latest recommendations on the diagnosis and treatment of endometriosis pain have recently been published, (Management of Endometriosis, updated practice bulletin, ACOG, July 2010), and although not entirely new, this data confirms what Dr. Leibman has been recommending for these patients. The recommendation is to start with conservative treatment, for instance, continuous birth control pills (skipping the placebo pills so that no period occurs, and NO, it is not harmful to your body to do this) and nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen. If these fail, then the family of drugs of which Lupron is the most commonly used, or progestins, can help by suppressing the disease. Medical therapy, however will not improve fertility for women trying to get pregnant since most of these medications suppress ovulation. Recurrence of the pain is common if the drugs are discontinued. Surgery to remove endometriosis tissue helps improve pregnancy rates among infertile women, but it is difficult to predict by how much. Vaginal ultrasound is the best way to diagnose endometriosis of the ovaries, and laparoscopy can also remove visible endometriosis lesions, but is not 100% effective in helping pain. The treatment of last resort for women with severe endometriosis is hysterectomy.

If you have symptoms of endometriosis, such as painful periods, painful intercourse, and /or difficulty becoming pregnant, see Dr. Leibman for a consultation.

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