Expected course of endometriosis is not clear. The endometrial lesions may remain unchanged and cause no symptoms without in some women whereas others may have progressive worsening of symptoms. Response to medical treatment is also variable.
The term endometriosis refers to the condition in which cells lining the inside of uterus (endometrium) are present in areas of the body outside of the uterus. The common places where these cells may become embedded include the lower abdomen of women, either on the inside lining of the pelvis or on the surface of the ovary, uterus or intestine.
Expected duration of Endometriosis
The natural course of symptomatic endometriosis is not clear. In some women the endometrial lesions may remain unchanged and cause no symptoms. In many women they progress and cause symptoms which may become increasingly severe. Occasionally the lesions may regress without treatment.
Birth control hormones or NSAIDs: According to experts, treatment for accidentally diagnosed lesions which are asymptomatic is not needed. Women with symptomatic endometriosis who do not plan to become pregnant in the near future may be given birth control hormones (patch, pills, or ring) or anti-inflammatories (NSAIDs) to control pain. The birth control hormones are effective in controlling pain and other symptoms and help shrink endometrial tissue. They may prevent worsening of the lesions as well. However these medications have to be taken for long term. They are generally safe with few side effects, but some women may develop recurrence of symptoms a few months after stopping treatment. They may need repeat treatment with medications or may be surgery.
GnRH agonists: Women with more severe symptoms or if birth control hormones and NSAIDs do control the symptoms may be treated with a stronger hormone therapy such as therapy with a gonadotropin-releasing hormone agonist (GnRH-a). Treatment with GnRH agonists is generally given for six months. They are effective in relieving symptoms in up to 85 percent of women while the treatment is continued. But symptoms may recur in some women a few months after completion of treatment. A major concern with GnRH agonistsis is development of osteoporosis with long-term oestrogen suppression. This has limited the use of GnRH agonists to short-term treatment intervals. If you have recurrent pain you may be given long-term GnRH agonist therapy with regular bone density scans and with other medications to prevent bone loss.
Surgery: Most women treated surgically are able to conceive (if they had problems with fertility) and have relief of symptoms. But according to studies some women may have recurrence after being treated surgically. However rate of recurrence is much less than that after medical therapy.
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