Is A Hysterectomy The Only Cure?

When a woman has endometriosis, the endometrium, or uterine lining, grows outside of the uterus and attaches to surrounding organs. The misplaced lining reacts to hormonal changes during a menstrual cycle and will shed and break down. With no place to go, the affected area becomes painful and inflamed. Pain management via medication and hormone therapy are the most common treatment options. Even with treatment, there is no guarantee the endometriosis will go away. A hysterectomy is a viable treatment option and is used for the most severe cases.

MY Texas Health Care OB/GYN Should I Consider a Hysterectomy for Endometriosis

What is endometriosis?

Endometriosis occurs when the uterine lining grows outside of the uterus. The tissue will break down and bleed during menstrual cycles. The displaced tissue has nowhere to go and the blood becomes trapped. Surrounding areas can become swollen and scar tissue or lesions can develop. When endometriosis occurs on the ovaries, cysts are formed. Rarely does the condition move past the pelvic region. The exact cause of endometriosis is unknown.

Symptoms of endometriosis

Symptoms are not always present with endometriosis. Common symptoms include abdominal pain, severe cramping, abnormal bleeding, painful periods, painful sex, and infertility. Discomfort while going to the bathroom can also be a sign of endometriosis. Pain is not always an indicator of the severity of the endometriosis. Endometriosis is often misidentified as pelvic inflammatory disease (PID), ovarian cysts, or irritable bowel syndrome (IBS).

What are the risk factors?

Genetics do play a role. If a woman’s mother had endometriosis, the woman has higher chances of having the condition. Starting menstruation at an early age or entering menopause early can place a female at a greater risk. Short cycles and long periods could be an indicator of endometriosis. Any condition affecting menstrual cycles or the reproductive tract can lead to endometriosis. Endometriosis typically does not start until many years after menstruation has begun.

Treatment options

There currently is no cure for endometriosis. Women with mild to moderate cases are offered pain medication and hormone therapy. Hormone levels change during menstruation, and medication can slow the growth of the displaced tissue. For women seeking to become pregnant, minor surgery is an option. The surgery will remove the endometrial implants while preserving the reproductive organs. To increase the chances of a successful pregnancy, ovary stimulating drugs may be offered to increase the number of eggs released. In vitro fertilization (IVF) or using an egg donor are also viable options.

When to consider a hysterectomy

A hysterectomy, removal of the uterus, was once the most common treatment for endometriosis. Today, physicians may recommend surgery after more conservative treatments have been successful. Women should understand that removal of the ovaries will cause the woman to enter early menopause. If the procedure is performed before the age of 35, increased medical complications related to metabolic conditions and cardiovascular diseases can occur. If a female wishes to still become pregnant, a hysterectomy should be avoided.

Exploring treatment options

Finding a doctor to manage pain and treatment is crucial. Understanding all viable options such as the various types of hormone treatments will help a female make an informed decision. Hysterectomies are reserved for only the most severe cases. Women with endometriosis should consult with a healthcare provider for treatment options and recommendations.

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