Endometriosis

 

TREATING ENDOMETRIOSIS AT THE TEPEYAC FAMILY CENTER

 

INTRODUCTION

Endometriosis is a painful female medical condition that can lead to infertility and a decrease in the joys of life.

How common is endometriosis among women?

Women in general population 1 out of 101
Women who are infertile  
Women with chronic pelvic pain 5 out of 10

A woman whose first-degree relative has endometriosis has a ten-fold increased risk of having this condition than the average woman.

THE HOW AND WHY

This serious medical condition occurs when cells that normally grow on the inside of the uterine (womb) lining end up inside the abdominal cavity (rather than in the vagina, on a tampon, or on a pad), either by flowing backwards through the fallopian tube, or flowing through blood vessels or lymph channels, or by transforming from normal peritoneal cells in a process called metaplasia. All women are vulnerable to this condition, but some women with lowered immune function, outflow obstruction like a narrow cervix, early age of starting menses, endometriosis in the family, repeated miscarriage, or heavy cycles are at an increased risk. Endometriosis is a disease dependent on the fluctuation of the hormones estrogen and progesterone in an ovulatory cycle which causes the implants to grow and then break down like the endometrium does.

THE SYMPTOMS AND SIGNS

Painful periods, chronic pelvic pain (especially low back pain), painful intercourse, and irregular cycles are all symptoms of this variable and unpredictable condition. Endometriosis may be associated with infertility by distorting the anatomy, or creating a chemical, immunological barrier to the health of the egg and sperm.

THE DIAGNOSIS

We diagnose endometriosis by listening to our patient’s complaints and by examining her abdomen with an endoscope. We can see the disease and see the adhesions and scars or the spots of endometriosis. Endometriosis also increases the CA-125 blood level and is the main reason why we do not routinely use that blood test for the screening of ovarian cancer.

THE TREATMENT

Conventional medical wisdom is to suppress ovulation, and thereby prevent the hormonal fluctuation which results in the growth of the endometrial lesions. Over the last four decades, the medical profession has used estrogens, testosterones, progestins, oral contraceptives, danazol, nonsteroidal anti-inflammatory drugs, and gonadotropin-releasing hormone agonists. However, all of these medications have side effects: weight gain, headaches, hot flashes, irritated vagina, and irregular bleeding. They act by trying to prevent ovulation or turn off portions of the immune system, both difficult challenges complicated with serious consequences. Natural progesterone, used during the luteal phase, may be helpful with less-significant side effects. For married women, pregnancy (if appropriate) followed by breastfeeding is also an excellent way to quiet the ovaries, allowing the body to heal naturally.

We also use surgery to help us diagnose and treat endometriosis. Inserting the endoscope/telescope through the belly button, we can see the disease and remove it with electricity or laser therapy. Since endometriosis is an "organic" condition, one that changes the structure of the pelvis, we think that meticulous destruction of the endometrial implants and reconstruction of the normal anatomy and the prevention of adhesion formation is crucial to helping restore bodily health from this condition.

At the Tepeyac Family Center, we treat each patient as an individual human person with dignity and integrity, and therefore tailor the therapy and treatment to each patient.

With this in mind, we might suggest other less invasive options:

These options could include the following:

CONCLUSION

Some or all of the above may be beneficial and help decrease the pain and suffering of endometriosis. It is a difficult condition, but with perseverance, hope, and openness to an "out of the box" approach to treatment, most patients can be helped significantly.

REFERENCES

  1. Farquhar CM. Extracts from the "clinical evidence." Endometriosis. BMJ 2000;320(7247):1449-52.
  2. Wu MH, Shoji Y, Chuang PC, Tsai SJ. Endometriosis: disease pathophysiology and the role of prostaglandins. Expert Rev Mol Med. 2007; 9(2):1-20.
  3. The Herbal Encyclopedia