How can my endometriosis be treated?

Objectives:

The aim of this study was to evaluate the long-term clinical effects of a levonorgestrel-releasing intrauterine device (LNG-IUD) on adenomyosis.

Study Design:

A LNG-IUD was inserted into 47 patients who were diagnosed with adenomyosis. Uterine volume, uterine artery blood flow, pictorial blood loss assessment chart (PBAC) scores, and the degree of dysmenorrhea were evaluated before and 36 months after insertion of the LNG-IUD.

Results:

Pain scores and PBAC scores dropped dramatically in 6 months and showed significant decrease after 36 months. A significant decrease in mean uterine volume was noted 12 months (156.85 +/- 49.79 mL to 118.64 +/- 41.36 mL; P < .001) and 24 months (128.84 +/- 48.70 mL; P < .001) after LNG-IUD insertion, but no significant differences were noted at 36 months. The mean pulsatility indices of both uterine arteries increased significantly 12 months after insertion (P = .002 for right; P = .011 for left) and decreased after 24 months without significance. Uterine volume and uterine blood flow were negatively correlated (Pearson's correlation, P < .05). Significant increase of uterine volume, pain scores, and PBAC scores were noted at 36 months compared with 12 months after insertion (P = .034, .021, and .001, respectively).

Conclusion:

For patients with clinical diagnosis of adenomyosis, the LNG-IUD is effective for the reduction of uterine volume with improvement of vascularity and relief of symptoms. However, the efficacy of LNG-IUD on uterine volume may begin to decrease 2 years after insertion.

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

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

  ENDOMETRIOSIS

•  What is endometriosis?
•  How prevalent is endometriosis?
•  What causes endometriosis?
•  How can my endometriosis be treated?
•  How can my doctor determine the cause of my pelvic pain?
•  What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
•  What is laparoscopy?
•  What are pelvic adhesions?
•  I have chronic pelvic pain. Could this be related to adhesions?
•  What is uterine retroversion (retroverted uterus)
•   Does a retroverted uterus cause symptoms?
•  How is a retroverted uterus treated?
•  What is pelvic congestion?
•  What causes pain associated with sexual intercourse (dyspareunia)
•  How can painful sexual intercourse (dyspareunia) be treated?
•  What is a pelvic mass?

  IRRITABLE BOWEL SYNDROME - IBS

•  What is irritable bowel syndrome?
•  How can we find out if I have irritable bowel syndrome?
•  Is irritable bowel syndrome (IBS) a common condition?
•  What causes IBS?
•  What is the pain associated with IBS like?
•  Can IBS be mistaken for gynaecological problems?
•  How can my IBS be treated?
•  What other treatments are available for IBS?
•  What can be done to reduce the amount of bowel gas(flatus)
•  What is constipation?
•  What causes constipation?
•   How can constipation be treated?
•  How could we summarise the treatments that are available for my pelvic pain?
•  Where can I obtain more information?
•  Pelvic Pain Support Groups.
•  Endometriosis Support Groups.
•  IBS Support Groups.




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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.