Women with endometriosis will be treated primarily with surgery but drugs and complimentary approaches can also be used in some selected group of patients.
Surgery is the most effective treatment. It involves laser, diathermy or excision of endometriosis superficial patches (also known as peritoneal deposits) and/or extensive removal of deep endometriotic nodules from the area between the posterior cervix and the anterior rectum, which in some instances involves excision of a small portion of the lower bowel.
In some cases, especially if fertility is no longer an issue and in severe debilitating cases of endometriosis, hysterectomy and oophorectomy (removal of the womb and ovaries) is recommended.
In 90% of cases the surgical treatment of endometriosis is performed laparoscopically, leading to a faster recovery and return to normal domestic/working duties, minimal skin scarring, short hospital stay (day case or one overnight stay following surgery) compared to laparotomy (open surgery).
While the incidence of complications is relatively low, injuries can occur when organs such as the bladder, ureters and bowel are involved.
- Combined oral contraceptive pill — taken continuously for 3- 6 months, no breaks, to stop the periods
- Progestogens — taken continuously for 6 months to stop the periods
- GnRH analogues — these drugs are given to interfere with the fluctuations of the cyclical female hormones. A state of “pseudo-menopause” is created and any menopausal side effects can be counteracted by taking hormone replacement therapy
Anti-inflammatory drugs such as ibuprofen are also used for pain relief only.
- Dietary changes — a diet to improve liver function and reduce oestrogen levels would include the following: plenty of fresh fruits and vegetables (vitamin C and caretinoids); reduced fat and protein, including dairy products, fatty meats and fast foods; avoidance of artificial additives, caffeine and alcohol; plenty of fibre and water
- Nutritional supplements — fish oils (omega 3 fatty acids)
- Group therapy — discussion of problems and treatments with women in similar situations in a support group scenario