Guest Author - Dr. Denise Howard
Endometriosis is a common problem in menstruating women. It is the most common cause of chronic pelvic pain and can be found in up to 80% of women who complain of pelvic pain. The pain can affect the quality of life, interfere with intimate relationships and can be quite debilitating. Endometriosis can also lead to infertility. Treatment is therefore geared at addressing each individual concerns.
The initial presentation of endometriosis is typically pain with the onset of menses. This is called dysmenorrhea. Nonsteroidal anti-inflammatory drugs such as ibuprofen (motrin, advil), mefenamic acid (ponstan) and naproxen (anaprox and aleve) can be effective in relieving this pain. Taking the medication as prescribed around the clock for the most painful days of the period can significantly reduce the pain. Initiating this medication 1-2 days before the onset of the period can also be effective in preventing the pain from occurring. For ibuprofen this is typically 600 mg every 6 hours or 800 mg every 8 hours and for naproxen it is 550 mg every 12 hours. It is important to limit the use of these drugs to only a few days as they can cause gastritis and stomach ulcers. Women with an allergy to aspirin should avoid this medication and those who have asthma should consult their health care provider before using.
The next treatment tier for pelvic pain due to endometriosis is the use of hormones. Birth control pills used in the traditional manner have a very high chance of relieving the pain. Initially it can be combined with drugs such as ibuprofen; however some women find that they may no longer need this drug after being on the pill for 3 months or more. Birth control pills can be used in a continuous fashion to address the pain associated with menstruation. Standard birth control pills can be manipulated so that menses occur 3-4 times a year or not at all. Now there are specific birth control pills designed so the user can have a period 4 times a year (Seasonale or Seasonique) or not at all (Lybrel). Other hormones that are also effective in treating the pain of endometriosis include progestin only methods. These options include the progestin only pill, which is taken continuously, the injections (Depoprovera), implants (Implanon) and the levonorgestrel intrauterine contraceptive device (Mirena).
If standard medical management isnít effective then more aggressive measures are indicated. These measures are certainly dependent on the individualís desire especially as it relates to their reproductive status. Surgical therapy can be diagnostic and therapeutic. Women with a known history of endometriosis may elect a medication that puts them into a temporary menopausal state or definitive surgical therapy. Women who do not have a definite diagnosis should under go a diagnostic procedure.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!