AshleyMommyto2
04-20-2009, 12:44 PM
Endometriosis
Endometriosis is a non-cancerous condition in which tissue similar to the endometrium (uterine lining) grow outside your uterus and adhere to other pelvic structures, most commonly the ovaries, bowel, fallopian tubes or bladder. It is a common cause of pelvic pain and infertility.
~Age of typical onset.~
Historically thought of as a disease that affects adult women, endometriosis is increasingly being diagnosed in adolescents, as well.
~Diagnosis
Gynecologists and reproductive endocrinologists, gynecologists who specialize in infertility and hormonal conditions, have the most experience in evaluating and treating endometriosis. The condition can be very difficult to diagnose, however, because symptoms vary so widely and may be caused by other conditions.Among the ways doctors diagnosis the disease are:
Laparoscopy. At present, laparoscopy is still the gold standard for the diagnosis of endometriosis and is commonly used for both diagnosis and treatment. Performed under general anesthesia, the surgeon inserts a miniature telescope called a laparoscope through a small incision in the navel to view the location, size and extent of abnormalities (such as adhesions) in the pelvic region. However, merely looking through the laparoscope can't diagnose deep endometriosis disease, in which the endometrial tissue is hidden inside adhesions or underneath the lining of the abdominal cavity. More extensive dissection is needed to diagnose and treat this type of disease.Many women have a combination of both deep and superficial (in which the endometrial tissue can be easily seen) endometrial disease.
Peritoneal tissue biopsy. During the laparoscopy, the doctor may remove a tiny piece of peritoneal tissue (the inner layer of the lining of the abdominal cavity) or other suspicious areas to help establish the diagnosis of endometriosis. This is recommended by the American College of Obstetricians and Gynecologists (ACOG), which notes that only an experienced surgeon familiar with the appearance of endometriosis should rely on visual inspection alone to make the diagnosis. A biopsy, however, is not mandatory to diagnose endometriosis, and a negative biopsy does not rule out the presence of this disease in other areas within the abdomen.
Ultrasonography, MRI and CT scan. An ultrasound uses sound waves to visualize the inside of your pelvic region, while an MRI uses magnets and a CT scan uses radiation. While these tests can suggest endometriosis or rule out other conditions, none can definitively confirm the condition. At this point, there is no noninvasive method to diagnosis endometriosis, which is frustrating for both women and their health care providers.
Pelvic exam. Your doctor may perform a physical examination, including a pelvic exam, to diagnose endometriosis. If all other causes of endometriosis can be ruled out, your doctor may treat the condition without any further exams.
Medical history. A detailed medical history may offer your health care professional the earliest clues in making the correct diagnosis. According to the Endometriosis Association, clues you may be at risk for endometriosis include painful bowel movements, frequent respiratory infections (a sign your immune system isn't working properly), allergies, chemical sensitivities, frequent yeast infections and severe menstrual cramps. A simple five-question test about these conditions can quickly determine if you are at risk.
Blood test. CA-125 is a blood test used to detect a certain protein commonly found in the blood of women with endometriosis. Although CA-125 commonly reveals an elevation in such blood protein in women with advanced endometriosis, it's not as sensitive to earlier stages of the disease and is often elevated in a host of other gynecologic conditions including uterine fibroids, abdominal or pelvic adhesions, prior infection and even ovarian cancer. Measurement of this blood level is not considered a standard part of the evaluation of a woman with suspected endometriosis.
~Treatment~
There is no cure for endometriosis. However, there are a number of options available for treating and managing the disease after diagnosis. They fall into four categories: medical, surgical, alternative treatments and pregnancy.
1. Medical. The most common medical therapies for endometriosis are nonsteroidal anti-inflammatories (NSAIDs), hormonal contraceptives (in oral, patch, or injectable applications) and other hormonal regimens, such as GnRH agonists (gonadotropin-releasing hormone drugs).
2. Surgical.The goal of any surgical procedure should be to remove endometriotic tissue and scar tissue. Hormonal therapies may be prescribed together with the more conservative surgical procedures.Surgical treatments range from removing the endometrial tissues via laparoscopy to removing the uterus, called a hysterectomy, often with the ovaries (called an oophorectomy). Surgery classified as "conservative" removes the endometrial growths, adhesions and scar tissue associated with endometriosis without removing any organs. Conservative surgery may be done with a laparoscope or, if necessary, through an abdominal incision.
3. Alternative treatments.Alternative treatments for relieving the painful symptoms of endometriosis include traditional Chinese medicine, nutritional approaches, exercise, yoga, homeopathy, acupuncture, allergy management and immune therapy.While some health care professionals may tell you these alternative paths to seeking pain relief from endometriosis are a waste of time, others may encourage you to try alternative methods of pain relief as long as they are not harmful to your condition. Either way, discuss any options you want to try with your health care professional. Also keep in mind that while these options may help relieve the pain of endometriosis, they won't cure the condition.
~ Endometriosis and Pregnancy~
While it can't be considered a "treatment" for endometriosis, pregnancy may relieve endometriosis-related pain, an improvement that may continue after the pregnancy ends. Health care professionals attribute this pregnancy-related relief to the hormonal changes of pregnancy. For example, ovulation and menstruation stops during pregnancy, and it's menstruation that triggers the pain of endometriosis. Plus, endometrial tissue typically becomes less active during pregnancy and may not be as painful or large without hormonal stimulation. However, in some cases, once the pregnancy and breastfeeding end and menstruation returns, symptoms may also return.If endometriosis has caused infertility, you have several treatment options, including surgery and drugs to stimulate ovulation, with or without intrauterine insemination or in vitro fertilization. The appropriate approach would be based on the results of a complete evaluation including an assessment of the male partner. In general, medicines that suppress the painful symptoms of endometriosis, such as GnRH agonists, oral contraceptives and danazol, do not improve the likelihood of pregnancy.
~Questions To Ask Your Dr.~
1. How many cases of endometriosis do you treat per month?
2. How do you make the diagnosis?
3. How many laparoscopic or laparotomy procedures do you perform each month?
4. Do you always use medical therapy before surgical therapy? If so, what therapies do you use?
5. Do you use GnRH agonists? If so, when? Before or after surgery?
6. What kinds of hormonal drug therapies have you used for patients with endometriosis?
7. Do you prescribe hormone therapy (HT) with GnRH agonist therapy? What are the risks and benefits of using HT for my health needs? Are there other options I can consider?
8. What side effects might I experience with the different hormonal therapies? How long do I have to be on these drugs for them to work effectively? Will my endometriosis come back when drug treatment ends?
9. Does endometriosis affect my ability to have children?
10. Do you think that alternative treatments—such as traditional Chinese medicines, changes in diet, homeopathy or allergy management—may help reduce the pain associated with endometriosis? Can you refer me to any practitioners who specialize in these areas and might be helpful to me?
11. When you perform laparoscopy for endometriosis, are you prepared to treat any disease that you see at that time or do you perform a diagnostic procedure only? What surgical approaches do you typically employ to treat endometriosis (for example, ablation, excision, laser, coagulation)?
All info for this was taken from:
http://www.healthywomen.org
http://www.endometriosis-treatments.com ... nancy.html (http://www.endometriosis-treatments.com/endometriosis-pregnancy.html)
Endometriosis is a non-cancerous condition in which tissue similar to the endometrium (uterine lining) grow outside your uterus and adhere to other pelvic structures, most commonly the ovaries, bowel, fallopian tubes or bladder. It is a common cause of pelvic pain and infertility.
~Age of typical onset.~
Historically thought of as a disease that affects adult women, endometriosis is increasingly being diagnosed in adolescents, as well.
~Diagnosis
Gynecologists and reproductive endocrinologists, gynecologists who specialize in infertility and hormonal conditions, have the most experience in evaluating and treating endometriosis. The condition can be very difficult to diagnose, however, because symptoms vary so widely and may be caused by other conditions.Among the ways doctors diagnosis the disease are:
Laparoscopy. At present, laparoscopy is still the gold standard for the diagnosis of endometriosis and is commonly used for both diagnosis and treatment. Performed under general anesthesia, the surgeon inserts a miniature telescope called a laparoscope through a small incision in the navel to view the location, size and extent of abnormalities (such as adhesions) in the pelvic region. However, merely looking through the laparoscope can't diagnose deep endometriosis disease, in which the endometrial tissue is hidden inside adhesions or underneath the lining of the abdominal cavity. More extensive dissection is needed to diagnose and treat this type of disease.Many women have a combination of both deep and superficial (in which the endometrial tissue can be easily seen) endometrial disease.
Peritoneal tissue biopsy. During the laparoscopy, the doctor may remove a tiny piece of peritoneal tissue (the inner layer of the lining of the abdominal cavity) or other suspicious areas to help establish the diagnosis of endometriosis. This is recommended by the American College of Obstetricians and Gynecologists (ACOG), which notes that only an experienced surgeon familiar with the appearance of endometriosis should rely on visual inspection alone to make the diagnosis. A biopsy, however, is not mandatory to diagnose endometriosis, and a negative biopsy does not rule out the presence of this disease in other areas within the abdomen.
Ultrasonography, MRI and CT scan. An ultrasound uses sound waves to visualize the inside of your pelvic region, while an MRI uses magnets and a CT scan uses radiation. While these tests can suggest endometriosis or rule out other conditions, none can definitively confirm the condition. At this point, there is no noninvasive method to diagnosis endometriosis, which is frustrating for both women and their health care providers.
Pelvic exam. Your doctor may perform a physical examination, including a pelvic exam, to diagnose endometriosis. If all other causes of endometriosis can be ruled out, your doctor may treat the condition without any further exams.
Medical history. A detailed medical history may offer your health care professional the earliest clues in making the correct diagnosis. According to the Endometriosis Association, clues you may be at risk for endometriosis include painful bowel movements, frequent respiratory infections (a sign your immune system isn't working properly), allergies, chemical sensitivities, frequent yeast infections and severe menstrual cramps. A simple five-question test about these conditions can quickly determine if you are at risk.
Blood test. CA-125 is a blood test used to detect a certain protein commonly found in the blood of women with endometriosis. Although CA-125 commonly reveals an elevation in such blood protein in women with advanced endometriosis, it's not as sensitive to earlier stages of the disease and is often elevated in a host of other gynecologic conditions including uterine fibroids, abdominal or pelvic adhesions, prior infection and even ovarian cancer. Measurement of this blood level is not considered a standard part of the evaluation of a woman with suspected endometriosis.
~Treatment~
There is no cure for endometriosis. However, there are a number of options available for treating and managing the disease after diagnosis. They fall into four categories: medical, surgical, alternative treatments and pregnancy.
1. Medical. The most common medical therapies for endometriosis are nonsteroidal anti-inflammatories (NSAIDs), hormonal contraceptives (in oral, patch, or injectable applications) and other hormonal regimens, such as GnRH agonists (gonadotropin-releasing hormone drugs).
2. Surgical.The goal of any surgical procedure should be to remove endometriotic tissue and scar tissue. Hormonal therapies may be prescribed together with the more conservative surgical procedures.Surgical treatments range from removing the endometrial tissues via laparoscopy to removing the uterus, called a hysterectomy, often with the ovaries (called an oophorectomy). Surgery classified as "conservative" removes the endometrial growths, adhesions and scar tissue associated with endometriosis without removing any organs. Conservative surgery may be done with a laparoscope or, if necessary, through an abdominal incision.
3. Alternative treatments.Alternative treatments for relieving the painful symptoms of endometriosis include traditional Chinese medicine, nutritional approaches, exercise, yoga, homeopathy, acupuncture, allergy management and immune therapy.While some health care professionals may tell you these alternative paths to seeking pain relief from endometriosis are a waste of time, others may encourage you to try alternative methods of pain relief as long as they are not harmful to your condition. Either way, discuss any options you want to try with your health care professional. Also keep in mind that while these options may help relieve the pain of endometriosis, they won't cure the condition.
~ Endometriosis and Pregnancy~
While it can't be considered a "treatment" for endometriosis, pregnancy may relieve endometriosis-related pain, an improvement that may continue after the pregnancy ends. Health care professionals attribute this pregnancy-related relief to the hormonal changes of pregnancy. For example, ovulation and menstruation stops during pregnancy, and it's menstruation that triggers the pain of endometriosis. Plus, endometrial tissue typically becomes less active during pregnancy and may not be as painful or large without hormonal stimulation. However, in some cases, once the pregnancy and breastfeeding end and menstruation returns, symptoms may also return.If endometriosis has caused infertility, you have several treatment options, including surgery and drugs to stimulate ovulation, with or without intrauterine insemination or in vitro fertilization. The appropriate approach would be based on the results of a complete evaluation including an assessment of the male partner. In general, medicines that suppress the painful symptoms of endometriosis, such as GnRH agonists, oral contraceptives and danazol, do not improve the likelihood of pregnancy.
~Questions To Ask Your Dr.~
1. How many cases of endometriosis do you treat per month?
2. How do you make the diagnosis?
3. How many laparoscopic or laparotomy procedures do you perform each month?
4. Do you always use medical therapy before surgical therapy? If so, what therapies do you use?
5. Do you use GnRH agonists? If so, when? Before or after surgery?
6. What kinds of hormonal drug therapies have you used for patients with endometriosis?
7. Do you prescribe hormone therapy (HT) with GnRH agonist therapy? What are the risks and benefits of using HT for my health needs? Are there other options I can consider?
8. What side effects might I experience with the different hormonal therapies? How long do I have to be on these drugs for them to work effectively? Will my endometriosis come back when drug treatment ends?
9. Does endometriosis affect my ability to have children?
10. Do you think that alternative treatments—such as traditional Chinese medicines, changes in diet, homeopathy or allergy management—may help reduce the pain associated with endometriosis? Can you refer me to any practitioners who specialize in these areas and might be helpful to me?
11. When you perform laparoscopy for endometriosis, are you prepared to treat any disease that you see at that time or do you perform a diagnostic procedure only? What surgical approaches do you typically employ to treat endometriosis (for example, ablation, excision, laser, coagulation)?
All info for this was taken from:
http://www.healthywomen.org
http://www.endometriosis-treatments.com ... nancy.html (http://www.endometriosis-treatments.com/endometriosis-pregnancy.html)