March is National Endometriosis Awareness Month

Endometriosis is an illness that affects women during their reproductive years, but frequently goes undiagnosed.  In women who suffer from the condition, endometrium-like tissue grows outside of the uterus, often throughout the abdominal cavity, leading to a variety of symptoms that arent routinely seen together.

According to the National Womens Health Information Center (NWHIC), those symptoms typically include:

  • "Very painful menstrual cramps
  • Pain with periods that gets worse over time
  • Chronic pain in the lower back and pelvis
  • Pain during or after sex
  • Intestinal pain
  • Painful bowel movements or painful urination during menstrual periods
  • Heavy and/or long menstrual periods
  • Spotting or bleeding between periods
  • Infertility (not being able to get pregnant)
  • Fatigue"

    The NWHIC also advises that while each person responds differently to treatment, the most common treatments generally consist of the following:

    "Pain Medication.  For some women with mild symptoms, doctors may suggest taking over-the-counter medicines for pain. These include: ibuprofen (Advil and Motrin) or naproxen (Aleve). When these medicines dont help, doctors may advise using stronger pain relievers available by prescription.

    Hormone Treatment.  When pain medicine is not enough, doctors often recommend hormone medicines to treat endometriosis. Only women who do not wish to become pregnant can use these drugs. Hormone treatment is best for women with small growths who dont have bad pain.

    Hormones come in many forms including pills, shots, and nasal sprays. Many hormones are used for endometriosis including:

    • Birth control pills block the effects of natural hormones on endometrial growths. So, they prevent the monthly build-up and breakdown of growths. This can make endometriosis less painful. Birth control pills also can make a womans periods lighter and less uncomfortable. Most birth control pills contain two hormones, estrogen and progestin. This type of birth control pill is called a "combination pill." Once a woman stops taking them, the ability to get pregnant returns, but so may the symptoms of endometriosis.
    • Progestins or progesterone medicines work much like birth control pills and can be taken by women who cant take estrogen. When a woman stops taking progestins, she can get pregnant again. But, the symptoms of endometriosis return too.
    • Gonadotropin releasing hormone agonists or GnRH agonists slow the growth of endometriosis and relieve symptoms. They work by greatly reducing the amount of estrogen in a womans body, which stops the monthly cycle. Leuprolide (Lupron®) is a GnRH agonist often used to treat endometriosis. GnRH agonists should not be used alone for more than six months. This is because they can lead to osteoporosis. But if a woman takes estrogen along with GnRH agonists, she can use them for a longer time. When a woman stops taking this medicine, monthly periods and the ability to get pregnant return. But, usually the problems of endometriosis also return.
    • Danazol is a weak male hormone. Nowadays, doctors rarely recommend this hormone for endometriosis. Danazol lowers the levels of estrogen and progesterone in a womans body. This stops a womans period or makes it come less often. Danazol also gives pain relief. But it often causes side effects like oily skin, weight gain, tiredness, smaller breasts, and hot flashes. Danazol does not prevent pregnancy and can harm a baby growing in the uterus. Since it cant be used with other hormones, like birth control pills, doctors recommend using condoms, diaphragms, or other barrier methods to prevent pregnancy.

    Surgery.  Surgery is usually the best choice for women with endometriosis who have a severe amount of growth, a great deal of pain, or fertility problems. There are both minor and more complex surgeries that can help. Your doctor might suggest one of the following:

    • Laparoscopy can be used to diagnose and treat endometriosis. During this surgery, doctors remove growths and scar tissue or destroy them with intense heat. The goal is to treat the endometriosis without harming the healthy tissue around it. Women recover from laparoscopy much faster than from major abdominal surgery.
    • Laparotomy or major abdominal surgery is a last resort treatment for severe endometriosis. In this surgery, the doctor makes a much bigger cut in the abdomen than with laparoscopy. This allows the doctor to reach and remove growths of endometriosis in the pelvis or abdomen. Recovery from this surgery can take up to two months.
    • Hysterectomy should only be considered by women who do not want to become pregnant in the future. During this surgery, the doctor removes the uterus. She or he may also take out the ovaries and fallopian tubes at the same time. This is done when the endometriosis has severely damaged them."

    If you suspect that you suffer from endometriosis, you should consult a physician right away.  Keeping a comprehensive journal of your symptoms can be particularly beneficial in arriving at an accurate diagnosis.

    Previously on the DC Metro Area Medical Malpractice Law Blog, we have posted articles related to:

    • Evidence that new mothers dont receive enough education regarding CMV prevention
    • Whether you eat less or exercise more, weight loss is good for the heart
    • Why unnecessary caesarean deliveries contribute to breathing problems

    For information about your legal rights, please click here or call the law firm of Regan Zambri & Long, PLLC at 202-463-3030.

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