How can my endometriosis be treated?

• Introduction
• Abortion
• Amenorrhoea
• Birth Control
• Bladder Symptoms
• Cancer in Women
• Childbirth
• Children and Teenagers
• Diet / Weight Loss
• Dysmenorrhoea
• Endometriosis
• Fibroids
• HRT
• Hirsutism
• Hysterectomy
• Infections
• Infertility
• Medication Drugs
• Menopause
• Menorrhagia
• Miscarriage
• Painful Sex
• Pap Smear Test
• PCOS
• Pelvic Pain
• Prevalence
• Common Causes
• Causes - Gynecological
• Causes - Non-Gynecological
• Dysmenorrhoea
• Diagnosis
• Laparoscopy
• Pelvic Adhesions
• Pelvic Congestion
• Retrograde Menstruation
• Retroverted Uterus
• Ovarian Cysts
• During Pregnancy
• Fibroids
• Endometriosis
• Pelvic Inflammatory Disease
• Mittelschmerz
• Irritable Bowel Syndrome - IBS
• Constipation
• Flatulence
• PMS
• Postpartum
• Pregnancy
• Self Esteem
• Sexual Problems
• Vaginal Discharge
• Vaginal Prolapse
• Vulval Symptoms

Underperforming Family Website?

Visit

Authors:

Howell R. Edmonds DK. Dowsett M. Crook D. Lees B. Stevenson JC.

Institution:

Queen Charlotte's/Chelsea Hospital, Goldhawk Road,London W6 0XG; United Kingdom.

Title:

Gonadotropin-releasing hormone analogue (goserelin) plus hormone replacement therapy for the treatment of endometriosis: A randomised controlled trial (1995-944).

Source:

Fertility and Sterility. Vol 64(3) (pp74-481), 1995.

Abstract:

Objectives:

To determine whether treatment of endometriosis with a GnRH analogue (GnRH-a; goserelin) combined with continuous estrogen and progestogen hormone replacement therapy (HRT) would prevent the hypoestrogenic effects, including loss of bone density, while maintaining efficacy for treatment of endometriosis.

Design:

Randomized controlled trial. Patients: Fifty premenopausal women with laparoscopically diagnosed endometriosis (revised American Fertility Score for endometriosis implants equal to four or greater) and significant symptoms of dysmenorrhoea, dyspareunia, and other pelvic pain.

Intervention:

Patients were randomized to receive either goserelin alone, 3.6 mg SC depot every 4 weeks for 24 weeks, or goserelin, 3.6 mg SC depot every 4 weeks for 24 weeks, plus HRT (25 mug transdermal 17beta E2 daily and 5 mg medroxyprogesterone acetate orally daily) for 20 weeks commencing with the second goserelin injection.

Results:

There was a significant reduction in the extent of pelvic endometriosis in both groups, with no difference between the groups. Both groups experienced an improvement in symptoms and signs, again with no difference between groups. Hypoestrogenic side effects of hot flushes and loss of libido were significantly less in the group that received HRT. The amount of bone mineral density loss was significantly less in the HRT group at the lumbar spine, although it was not prevented completely.

Conclusion:

The addition of HRT to GnRH-a for the treatment of endometriosis did not reduce the efficacy of treatment, and adverse hypoestrogenic effects were decreased, although not abolished.

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.