Endometriosis Care

What is endometriosis?
Defined as the presence of endometrial – like glands in any site outside the uterus
How common is the disease?
Endometriosis is a gynecologic condition that occurs in up to 50% of pre-menopausal women. Occurs in 38% of infertile women and 71-87% of women with Chronic Pelvic Pain.
Does it run in families?
A familial association has been documented. Women with a first degree relatives affected with endometriosis have a 10-fold increase of having the disease.
How do you get it?
We do not know the real cause of the disease. Some people believe it happens embryologically, others because of menstrual cycle flowing through the tubes and into the abdomen.
What are the symptoms?
Pelvic Pain is typical. Pain frequently commences prior to menses, deep pelvic pain with intercourse that worsens during the time of menstruation, and sacral backaches are common. Women can even experience diarrhea with bowel involvement and blood in the urine when the bladder is involved.
How is endometriosis diagnosed?
Direct visualization confirmed by histological examination if lesions have a non-classical appearance.
What medical therapy is available?

  • Birth control pills in conjunction with Non-steroidal anti-inflammatories will be the least expensive regimen. This should not be tried for more than 3-4 months if no relief of pain is experienced.
    Danazol can also be used but can cause birth defects if accidental pregnancy occurs while on the drug. Should I have a hysterectomy? A Hysterectomy is the final step in treatment. Endometriosis is estrogen sensitive. Recurrence rates for pain are almost 60% if ovaries are left at the time of hysterectomy. If ovaries are removed there is only a 10% rate. Depending on your age you need to fully consider the effects and risk/benefit ratio of a premature surgical menopause.

  • Progestins can also be used
  • GnRH agonist (LUPRON) is the best studied to reduce the size of endometriosis lesions. Lupron does put you into a reversible menopausal type state. Add back therapy may be needed to help with symptoms such as hot-flashes, mood swings and insomnia. Lupron should not be used for more than 6 months without add back therapy because it can cause bone loss without add back therapy.