How can my endometriosis be treated?

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Authors:

Survey ES. Barbieri R. Bradshaw K. Brill A. et al

Institution:

Dr. E.S. Survey, 9675 Brighton Way, Beverly Hills, CA 90210; United States.

Title:

Add-back therapy and gonadotropin-releasing hormone agonists in the treatment of patients with endometriosis: Can a consensus be reached? (1999)

Source:

Fertility and Sterility. Vol 71(3) (pp20-424), 1999.

Abstract:

Objectives:

To reach a consensus on the role of add-back therapy for patients with endometriosis administered GnRH agonists (GnRH-a).

Design:

Results of consensus conference reviewing MEDLINE search of English language abstracts of both prospective and retrospective series.

Setting:

Consensus conference of 31 specialists in gynecologic surgery and reproductive endocrinology.

Patients:

Patients with symptomatic endometriosis who were candidates for GnRH-a therapy in treatment courses ranging in duration from 6 to 12 months.

Interventions:

Oral steroidal and nonsteroidal add-back regimens.

Main Outcome Measure(s):

Alteration in painful symptoms, extent of disease, vasomotor symptoms bone mineral density, and serum lipid profile.

Results:

When added to GnRH-a for 6 months, both 2.5 mg of norethindrone and 0.625 mg of conjugated e quine estrogens with 5 mg/d of medroxyprogesterone acetate provide effective relief of vasomotor symptoms and decrease but do not eliminate bone mineral density loss. During 12 months of GnRH-a therapy, bone mineral density loss is eliminated effectively with an add-back of 5 mg of norethindrone acetate alone or in conjunction with low-dose conjugated e quine estrogens. Organic bisphosphonates also may play a role.

Conclusion(s):

In patients with symptomatic endometriosis, the efficacy of GnRH agonists may be preserved and therapy prolonged while overcoming hypoestrogenic side effects with the use of appropriate add-back regimens.

Please click on the required question.

•  Pelvic Pain. Is this a common problem?
•  What are the common causes of pelvic pain in women?
•  What are the more common gynaecological causes of pelvic pain?
•  What are the more common non-gynaecological causes of pelvic pain?
•  What are primary and secondary dysmenorrhoea - painful periods?
•  What is retrograde menstruation?
•  How can dysmenorrhoea - painful periods be treated?
•  What are ovarian cysts?
•  How do ovarian cysts cause pain?
•  How are ovarian cysts diagnosed?
•  How are ovarian cysts treated?
•  I think I may be pregnant and I have some pelvic pain. What should I do?
•  What is pelvic inflammatory disease and how can it be treated?
• Mittelschmertz

FIBROIDS

• 14 What are fibroids?
• 15 I have fibroids. What difficulties might they cause for me?
• 16 How are fibroids diagnosed?
• 17 How could my fibroids be treated?

ENDOMETRIOSIS

• 18 What is endometriosis?
• 19 How prevalent is endometriosis?
• 20 What causes endometriosis?
• 21 How can my endometriosis be treated?
• 22 How can my doctor determine the cause of my pelvic pain?
• 23 What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
• 24 What is laparoscopy?
• 25 What are pelvic adhesions?
• 26 I have chronic pelvic pain. Could this be related to adhesions?
• 27  What is uterine retroversion (retroverted uterus)
• 28  Does a retroverted uterus (backward tilted uterus) cause symptoms?
• 29 How is a retroverted uterus - backward tilted uterus - treated?
• 30 What is pelvic congestion?
• 31 What causes pain associated with sexual intercourse (dyspareunia)
• 32 How can painful sexual intercourse (dyspareunia) be treated?
• 33 What is a pelvic mass?

IRRITABLE BOWEL SYNDROME - IBS

• 34 What is irritable bowel syndrome?
• 35 How can we find out if I have irritable bowel syndrome?
• 36 Is irritable bowel syndrome (IBS) a common condition?
• 37 What causes IBS?
• 38 What is the pain associated with IBS like?
• 39 Can IBS be mistaken for gynaecological problems?
• 40 How can my IBS be treated?
• 41 What other treatments are available for IBS?
• 42 What can be done to reduce the amount of bowel gas(flatus)
• 43 What is constipation?
• 44 What causes constipation?
• 45  How can constipation be treated?
• 46 How could we summarise the treatments that are available for my pelvic pain?
• 47 Where can I obtain more information?
• 48 Pelvic Pain Support Groups.
• 49 Endometriosis Support Groups.
• 50 IBS Support Groups.

Thank you for choosing to visit us.

This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.