National Endometriosis month and NSAIDS to contraceptives

It’s National Endometriosis Month and we appreciate all the emails that our twitter post generated. Endometriosis can affect up to 10 % of women of childbearing age and is worth a closer look.

The tissue that lines the uterus is endometrium and endometriosis describes a condition where women develop tissue that is misplaced outside the uterus which looks and acts like endometrial tissue. Each month, this tissue builds up and breaks down like endometrium which can lead to scar tissue, cysts and inflammation, bleeding, pain and swelling.

There are 4 stages of endometriosis, ranging from miminal to severe based on the depth and size, amount and location of the misplaced endometrium. The American Society of Reproductive Medicine developed these stages and they can be found on their site (www.asrm.org) . There is a strong review of endometriosis on the Hopkins Medicine site at:http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/gynecological_health/endometriosis_85,P00573Hopkins is the top rated OB, GYN center in the US.

 Back to the treatment side of endometriosis. Endometriosis is cited as one of the 3 major causes of infertility and there are some theories about a genetic factor or factors relating to the disease. Some current research is aimed at some immune system role in the problem (visit www.clinical trials.gov and enter endometriosis).

Pain is a common symptom of endometriosis as is infertility, heavy menstrual flow, cramps, constipation, pain during urination during menstruation and fatigue among others. Treatment of pain is usually tailored to the amount of pain. Non-Steroidal-Anti-Inflammatory Drugs) like naproxen (Aleve, others or ibuprofen (Motrin, others) are often used—but a frank discussion with your doctor about how helpful NSAIDS are is smart.

Additional steps may include:

  • Oral contraceptives (to prevent ovulation and lower menstrual flow- estrogen and progestin containing)
  • Danazol (a male-type hormone)
  • Progestins
  • GnRH agonist—which shuts down hormone production by the ovaries and creates a menopausal-like state.

Beyond pain medicines, and the other steps above--some clinicians advocate watchful waiting (challenging depending on how severe your symptoms are), others start with relaxation approaches, 
warm baths, exercise, Traditional Chinese Medicine (TCM), nutrition strengthening, allergy and immune therapy, preventing constipation and a heating pad on the painful area.  A pill isn’t always the answer, but it, or some pills may be required depending on the severity of the endometriosis.
 

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