In the Media
|
“Hope and Treatment is Available to Those Who Suffer from Endometriosis“ Download the PDF version:
"A major problem is that only a handful of experts understand this disease," said Andrew Cook, MD, founder and medical director of Vital Health Institute in Los Gatos, and an internationally recognized endometriosis and pelvic pain expert with 20 years of experience. "There is no cure," Cook said, "however, just like breast cancer... most women with endometriosis who are properly treated will not have recurrent disease if it is caught early and treated correctly." By definition, endometriosis is a disease process where the inside lining of the uterus – the endometrium – flows back up inside of the body around the ovaries and bowel, implants and begins to grow, Cook explained. "In reality, this disease can be like having tens or hundreds of excruciatingly painful blisters covering the inside of the pelvis." "We do not know what causes endometriosis," Cook continued. "There is a genetic predisposition, which means if you have a relative with endometriosis, you have an increased risk of getting endometriosis. Most women begin to have symptoms during their teenage years, while most experience symptoms for years prior to receiving a diagnosis in their 20s or 30s." Endometriosis is most common in women in their 30s and 40s but it can occur any time in women who menstruate, said Dr. I. Tan, an obstetrician and gynecologic surgeon at Simi Obstetrics and Gynecology Medical Group in Simi Valley. "It occurs most often in women who have never had children," Tan explained. "Women with a mother, sister, or daughter who have had endometriosis also are more likely to have it. It is also found in about three quarters of the women with chronic pelvic pain." The cause of endometriosis is not known, "but there several suggested theories," Tan continued. For instance, "retrograde menstruation is a theory that menstrual blood and tissue flows backward from the uterus through the fallopian tubes and into the pelvis," Tan said. "This theory was proposed from the observation that women who have a partial or complete obstruction of the uterus or cervix that prevents normal menstrual flow are more likely to have endometriosis." Many women with endometriosis have no symptoms, Tan added. "If they have symptoms, pelvic pain is the main symptom of endometriosis. Pain usually occurs just before or during the menstrual cycle and during or after sex. Pain may also occur during bowel movements or urination." "These possible warning signs may indicate the presence of endometriosis – which, in severe states, can cause infertility," Tan said. "Although these symptoms may be a sign of endometriosis, they could also be signs of other problems like pelvic inflammatory disease. Thus other disorders need to be ruled out first before settling on the diagnosis of endometriosis," she said. "The amount of pain also does not always correlate with the severity of the endometriosis. Some women with slight pain may have severe cases and vice versa." Treatment depends on the extent of the disease, symptoms, and whether the patient wants to have children. "Endometriosis may be treated with medication, surgery, or both," Tan said. "Although treatments may relieve pain and infertility for a time, symptoms may return after treatment." Nonsteroidal anti-inflammatory drugs (NSAIDs) and hormones are the medical treatments available. "The NSAIDs are used to relieve pain. Hormones are used to relieve pain and to also help slow the growth of endometrial implants and may prevent new adhesions." The most commonly prescribed hormones include birth control pills (which can relieve pain and regulate the period); gonadotropin-releasing hormone (which puts women in temporary menopausal state by shutting down the ovaries, thus shrinking the endometriosis and relieving pain); progestin (which works against the effect of estrogen on tissues and thus shrinks the endometriosis); and danazol, which shrinks the endometriosis by lowering estrogen and progesterone levels. "These medications are not for everyone – as with most medications, there are side effects," Tan said. "Some women may find the relief of pain is worth the side effects and these medications do not relieve pain in all patients." Surgery is another option for treatment, Tan said. "Surgery may be done to remove endometriosis and adhesions. In most severe cases, surgery is often the best option. Laparoscopy is the most common procedure, with removal or ablation of the endometrial implants. Patients may have relief from pain after surgery but in about half the women who have undergone surgery, symptoms returned within one year. The more severe the disease, the more likely symptoms return." If pain is severe and doesn't go away after treatment, a hysterectomy may be an option and endometriosis is also less likely to return if the ovaries are also removed. "Most of the time this procedure is curative but there is a small chance that symptoms may return," Tan said. Endometriosis is a long-term condition, Tan further emphasized. "Many women have symptoms that occur off and on until menopause. Menopause usually cures all symptoms of endometriosis." At the Vital Health Institute, "I offer advanced, minimally-invasive surgery using state-of-the-art wide excision with complete removal of endometriosis, removal of scar tissue, removal of endometriosis from the bladder and bowel," said Cook. "Nearly 90 percent of women with endometriosis and pelvic pain respond to wide excision with removal of the endometriosis." In his experience, he has encountered many myths surrounding the disease, such as patients with endometriosis and pelvic pain are crazy, pelvic pain is all in her head, hysterectomy cures endometriosis, pregnancy cures endometriosis, moderate to severe pelvic pain with your period is normal, and there is no effective treatment for endometriosis. "There is hope right now – there is effective treatment right now," Cook said. "Moderate to severe pelvic pain is not normal, and women who experience this kind of pain should see a doctor they trust, who listens and validates what they are going through and understands how to treat endometriosis and pelvic pain." |
Hope and Treatment is Available to Those Who Suffer from Endometriosis
Described as a painful, chronic disease that affects more than five million women and girls in the United States and Canada, endometriosis is a disease with no known cause or cure. Experts are working to alleviate this disease through a range of treatments as research in this area continues..
