Treatment FAQ

explain how treatment modalities differ for endometriosis

by Mr. Jamal Terry Published 3 years ago Updated 2 years ago

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2. OTC anti-inflammatory drugs...

3. Castor oil...

4. Turmeric...

5. Choose anti-inflammatory foods...

6. Pelvic massages...

7. Ginger tea...

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What are the treatment options for endometriosis?

Treatment of endometriosis pain may include several different modalities, including medication, therapy, trigger point and nerve injections, and laparoscopic surgery. Medications used to treat endometriosis include:

Which imaging modalities are used in the diagnosis of endometriosis?

Magnetic resonance imaging (MRI) and ultrasonography (US) (which includes transabdominal, transvaginal and transrectal approaches) are the most widely reported diagnostic modalities for endometriosis.

Can endometriosis surgery improve fertility?

In most cases, health care providers will recommend laparoscopy to remove or vaporize the growths as a way to also improve fertility in women who have mild or minimal endometriosis. Although studies show improved pregnancy rates following this type of surgery, the success rate is not clear.

Is there a simple non‐invasive test for endometriosis?

Currently, no simple non‐invasive test for the diagnosis of endometriosis is routinely implemented in clinical practice. Surgical diagnostic procedures for endometriosis include laparoscopy (minimal access surgery) or laparotomy (open surgery via an abdominal incision).

What are the different treatment options available for endometriosis?

Therapies used to treat endometriosis include:Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. ... Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. ... Progestin therapy. ... Aromatase inhibitors.

Which treatment is appropriate in the management of endometriosis?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first-line treatment for endometriosis, followed by hormone therapy. Laparoscopy can be used to confirm the diagnosis before additional treatments are pursued; empiric therapy with another suppressive medication is also an option.

What is the new treatment for endometriosis?

In the summer of 2018, the Food and Drug Administration (FDA) approved the first oral gonadotropin-releasing hormone (GnRH) antagonist, called Elagolix (Orilissa), to help with moderate to severe pain from endometriosis. Elagolix is a daily pill . It works by stopping the production of estrogen.

What is the first-line of treatment for endometriosis?

OCPs, progesterone-only OCPs, and medroxyprogesterone acetate (Provera) should be used as first-line therapies for treating pain associated with endometriosis.

What is the most common treatment for endometriosis?

Medications range from pain relief drugs (such as paracetamol and anti-inflammatories), to hormonal treatments that suppress ovulation and periods. Surgery can be used to remove or destroy the endometriosis. The most common surgery approach is laparoscopy (key-hole surgery).

What is the initial imaging modality of choice for evaluating possible endometriosis?

Transvaginal ultrasonography is the preferred imaging modality for women with suspected endometriosis.

Why there is no treatment for endometriosis?

An All Party Parliamentary Group inquiry into endometriosis care found that there have been no significant treatment breakthroughs because endometriosis research hasn't been a priority. Worse, it means we still don't fully understand what causes the disease, making it difficult to develop a cure.

Which of the following medications are used to treat endometriosis?

What is the best medication for endometriosis?Best medications for endometriosisProvera (medroxyprogesterone acetate)ProgestinOralNaprosyn or Aleve (naproxen)Nonsteroidal anti-inflammatoryOralAdvil or Motrin (ibuprofen)Nonsteroidal anti-inflammatoryOralDanazolAndrogenOral5 more rows•May 10, 2020

What are the goals of therapy for this patient's endometriosis pain?

The goal of medical therapy is to reduce pain by decreasing inflammation as well as ovarian and local hormone production (Table 1). Complete estrogen suppression may not be necessary to relieve endometriosis-associated pain.

How is endometriosis diagnosed without surgery?

In January 2019, the American Journal of Obstetrics and Gynecology published a “Call to Action” to diagnose endometriosis “clinically.”[3] This means that, rather than requiring surgery for diagnosis, doctors should give suspected endo patients a diagnosis of endometriosis without laparoscopy based on symptoms, family ...

How is laparoscopy done for endometriosis?

Endometriosis is diagnosed surgically by laparoscopy. During laparoscopy, a thin viewing tube (called a laparoscope) is passed through a small incision in the abdomen. A second incision may be made on the lower abdomen to provide an additional opening for surgical instruments.

How many stages of endometriosis are there?

There are four stages of endometriosis, a condition that causes abnormal tissue to grow outside of the womb, that range from mild endometriosis to severe endometriosis. The severity of symptoms does not necessarily indicate the stage of endometriosis.

What is the only permanent treatment for a uterus?

Removal of the uterus ( hysterectomy ), ovaries ( oophorectomy ), or ovaries and fallopian tubes (salpingo-oophorectomy) is the only permanent treatment and may be recommended for patients who: Have tried other treatments and still have severe symptoms. Do not wish to become pregnant in the future.

What is the condition where the lining of the uterus grows outside the womb?

Endometriosis is a common condition in which tissue similar to the lining of the uterus (the endometrium) grows outside the womb and can cause pelvic pain and difficulty getting pregnant. It most commonly occurs in the ovaries, fallopian tubes, the bowel, and the areas in front, in back, and to the sides of the uterus.

Where do endometrial fragments travel?

Endometrial fragments may travel through blood vessels or the lymphatic system to other parts of the body, which could explain how endometriosis cells end up in distant parts of the body, such as the lung, brain, skin, or eye.

Can endometriosis cause pelvic pain?

Usually filled with old blood resembling chocolate syrup, sometimes referred to as “chocolate cysts”. Cysts are benign (not cancerous) but may also cause pelvic pain. Endometriosis symptoms usually go away when a woman goes through menopause.

Is endometriosis surgery invasive?

Endometriosis surgery is often done la paroscopically, which is less invasive than open surgery. The goal of surgery is to remove endometriosis and scar tissue, but it is not a permanent cure and endometriosis tissue often grows back and pain returns without post-surgical treatment such as hormonal birth control.

Can endometrial tissue replace other tissue?

One theory is that endometrial tissue may have the ability to replace other types of tissues outside the uterus. First-degree relatives of women who have endometriosis are more likely to develop the disease, which means there may be a genetic predisposition. Immune system dysfunction may play a role.

Superficial peritoneal lesions

Superficial peritoneal lesions are found on the peritoneum. This is the tissue that lines the pelvic cavity and organs. It’s the most common type of lesion, and accounts for about 80 percent of endometriosis lesions.

Endometriomas

Endometriomas are a type of cyst that most often appear on the ovaries, although they can, in some instances, appear on other tissues as well.

Deep infiltrating endometriosis (DIE)

Deep infiltrating endometriosis (DIE) refers to endometriosis lesions that penetrate 5 millimeters (mm) or more into the affected tissue. It’s estimated to affect about 20 percent of individuals with endometriosis.

The American Society for Reproductive Medicine (ASRM) staging system

The American Society for Reproductive Medicine (ASRM) criteria is most often used to stage endometriosis. This uses a scoring system to evaluate:

The Enzian classification

One of the drawbacks of the ASRM system is that it does not account for the presence of deep infiltrating endometriosis (DIE), which affects tissues other than those included in the ASRM system.

The Endometriosis Fertility Index (EPI)

Another drawback of the ASRM system is that it does not reflect how endometriosis can affect your fertility. This is often an important concern for people with endometriosis who want to get pregnant.

Other treatments for endometriosis

If surgery is not an option for you, there are other endometriosis treatments that may help, such as:

Abstract

About 10% of women of reproductive age suffer from endometriosis. Endometriosis is a costly chronic disease that causes pelvic pain and subfertility. Laparoscopy, the gold standard diagnostic test for endometriosis, is expensive and carries surgical risks.

Plain language summary

How accurate are imaging tests in detecting endometriosis? Can any imaging test be accurate enough to replace or reduce the need for surgery in the diagnosis of endometriosis?

Objectives

To provide the estimates of the diagnostic accuracy of imaging modalities for the diagnosis of pelvic endometriosis, ovarian endometriosis and deeply infiltrating endometriosis (DIE) versus surgical diagnosis as a reference standard.

Results

The literature search identified 32,275 references as follows: MEDLINE (n = 7391), EMBASE (n = 12,161), CENTRAL (n = 445), CINAHL (n = 668), PsycINFO (n = 174), Web of Science (n = 7425), LILACS (n = 420), OAIster (n = 446), TRIP (n = 1648), trial registers for ongoing and registered trials (n = 523), MEDION (n = 190), DARE (n = 99), PubMed, a ‘Systematic Review’ search (n = 418) and simple search PubMed (n = 267).

Discussion

Data from 4807 women of reproductive age with symptoms of endometriosis who undertook a non‐invasive imaging test followed by diagnostic surgery for endometriosis were analysed in 49 articles published from 1993 through 2015. This is the first diagnostic test review to use Cochrane methods and the most comprehensive review to date.

Authors' conclusions

Transvaginal ultrasound (TVUS), the most studied technique, showed only moderate sensitivity, albeit high specificity for pelvic endometriosis and DIE. For these conditions, TVUS did not qualify as a replacement test or a triage test but approached the criteria for a SpPin triage test.

Notes

A single review on non‐invasive tests for diagnosis of endometriosis was planned but was split into several smaller reviews to facilitate data handling and interpretation as a result of the abundance and diversity of suggested tests. We generated this review from a generic protocol, which had been designed for all reviews in these series.

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