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Is there a cure for endometriosis?
Unfortunately, none of the treatments, with the general exception of a hysterectomy and removal of ovaries, is a permanent cure for endometriosis. In the majority of women pregnancy leads to an improvement or a disappearance of the condition, particularly during the later months of the pregnancy; however the beneficial effects are usually only temporary and many women will experience a recurrence within a few years.
How is endometriosis treated?
There are a range of options available for the management of endometriosis. It is important to carefully consider all of the options available and to discuss them with your health practitioner before beginning any treatment.Treatment will depend on the severity of endometriosis, the symptoms occurring and if having a baby is desired. Treatments can include
surgery,
hormonal management ,
natural therapies and lifestyle changes,
as well as medicines for pain relief.
The treatment of endometriosis, once the diagnosis has been made, will depend on many factors including:
1. The symptoms experienced and their severity e.g. pain / infertility
2. The stage of endometriosis and site(s)
The goal of treatment is to improve and reduce symptoms, eliminate endometriotic implants and maximise fertility if desired.
Because endometriosis is a chronic disease, the recurrence rate is high despite both hormonal and surgical treatments.
Hormonal management
Hormonal therapies may be used to suppress growth of endometrial cells in endometriosis in the short-term but also for longer-term therapy. Hormone therapies may be used to treat mild endometriosis, or may be used before or after surgery to remove endometriosis. Sometimes the hormones, in particular the Pill, are used to suppress the period with the aim of suppressing the recurrence of endometriosis as a form of maintenance therapy. For more information see Hormonal management
Surgical treatment
Surgical treatment removes the sites of endometriosis but the degree of surgical removal will depend on the degree of the disease, whether the endometriotic implants are superficial and visible, nodular or infiltrating into other organs such as endometriomas (chocolate cysts in the ovaries) or the bowel.
Laparoscopic surgery can be performed in most women but it is recommended that surgery be performed by a specifically trained laparoscopic surgeon. There are different laparoscopic techniques to remove endometriotic deposits including excision, diathermy or burning and laser therapy.
Endometriomas, or chocolate cysts, within the ovaries should be completely removed if over 3cm, taking only the cyst and preserving the ovary. For more information see Surgical treatment
Recurrence of endometriosis
Regardless of the treatment used however, some women will have a recurrence of their endometriosis. Approximately 20 per cent of women will have a recurrence within twelve months and as many as 50 per cent within five years.
