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Endometriosis: making a decision regarding treatment ENDOMETRIOSIS: MAKING A DECISION REGARDING TREATMENT
Making the decision about which treatment you will have is often difficult. You should allow yourself time to explore the options to make the decision that is right for you. Do not allow yourself to be pushed by others into making a decision.
In order to make the best decision you need to consider your lifestyle, goals, values and feelings, as well as the severity of your disease and its symptoms, and the purpose of the treatment. You also need to weigh up all the potential advantages and disadvantages of each of the treatments against the possible relief that it will bring.
Get as much information as you can. Make an appointment with your gynecologist to ask any questions that you may have.
Do not hesitate to get a second opinion if you have any concerns or doubts.
It helps if you discuss the issues with your partner, a friend or another woman with endometriosis.
No treatment offers a magical or permanent cure for endometriosis.
It is not possible to give reliable figures for the success rates of the different types of treatment because few large-scale studies have been carried out. Gynecologists believe that, overall, success is related to the severity of your condition: the milder your disease the more likely that your treatment will be successful. Nevertheless, there is a wide variation in the way women respond to treatment and it is not possible to predict how you will respond.
Women react differently to each treatment and you may find that you need to try two or three treatments before you find one that works for you.
Regardless of the type of treatment used, some women will have a recurrence of their symptoms. It seems that approximately 20% of women will have a recurrence within 12 months and as many as 50% will have a recurrence within five years.
Anne's story
Diagnosed with endometriosis at the age of 2 7, 1 was told that the best treatment was to take the male synthetic hormone, Danazol. I had to take 600 milligrams a day for nine months. I was a little apprehensive about taking Danazol but realized that not all women suffered the side effects that I had read about. I decided that if the Danazol was going to get rid of the terrible period pain I was suffering every month then I was prepared to take the tablets.
Every day whilst on the medication I looked for side effects from the drug. I jumped on the scales every morning to see if I had gained weight. I peered in the mirror to see if I was growing a beard and I inspected my skin to make sure I wasn't developing acne.
I was surprised that I actually felt good during the time I took Danazol. For the first time that I could remember my whole life didn't revolve around my menstrual cycle. No periods and no pain for nine months was sheer bliss. I did develop a few side effects, but the relief I obtained from the pain far outweighed the side effects.
I gained about six kilograms in weight. This gain appeared to be more a body building, muscular weight increase which didn't bother me. I experienced some nausea and occasional vomiting but it wasn't a major problem.
The only other side effect I experienced which, unfortunately, has been irreversible was a deepening of my singing voice. My upper range decreased four tones. Luckily, I am not a professional singer but I still get frustrated occasionally at the change. At the end of the Danazol treatment, a laparoscopy revealed no evidence of endometriosis and I subsequently had two children. Seven years later I had another laparoscopy and was again diagnosed as having endometriosis.
This time I took the trial drug Buserelin, one of the GnRH agonists. It was in the form of a nasal spray. I took the drug for six months and during that time had no side effects. I had been told by my doctor that I might experience hot flushes, dry vagina, depression or headaches. Luckily, I didn't experience any of them. Another laparoscopy at die end of the Buserelin treatment revealed that apart from one endometrial cyst, the endometriosis had disappeared.
Six weeks after this laparoscopy I was back in hospital having the cyst and left ovary removed. Although I was a registered nurse and familiar with hospital environments, I was still nervous at the prospect of major surgery.
I need not have worried - everything went according to the plan my doctor and I had discussed. I had a continuous morphine infusion for the first 24 hours after the operation - it was great, I experienced very little pain. I was up walking around the day after surgery and drinking and eating the day after that.
I was discharged from hospital five days after the operation and was back at part-time work and playing sport six weeks after the surgery.
Three years later I feel great. I still get some ovulation and period pain every month, but nothing like the severe, debilitating pain I experienced before I had treatment.
*32 /41/5*
WOMEN’S HEALTH
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