endometriosis Archives - Page 13 of 16

Lupron or Laparoscopy to Diagnose Endometriosis?

Published on May 16, 2013

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I recently had my first pre-operative appointment for the diagnostic laparoscopy I’m having soon. I was nervous, and had a list of questions for my doctor. This was the second gynecologist I’d seen to discuss diagnosing endometriosis; my other doctor is too elderly to operate. She was frank and very straightforward.

“There are two options for diagnosis: a laparoscopy and chemically-induced menopause with Lupron. If we do a laparoscopy and find nothing, we still have other diagnostic options. It’s a good sign that you’re doing better after a brief time on hormone-replacement therapy and then extended-course birth control. If we do find nothing, we’ll try Lupron, which will chemically induce menopause. If Lupron doesn’t work, you don’t have endometriosis, and you’ll be looking at other tests.
We’ll schedule you for one more pre-operative appointment where you can ask all the questions you have and you’ll register with the hospital where the surgery will be performed. You’ll go home the same day, and you should take it easy for three days. In two weeks, you’ll have a follow-up appointment where we’ll go over what we found inside your pelvis and check your surgery sites for infection.
Then, assuming you do have endometriosis, we’re going to evaluate you every six months to a year. You’re going to tell me how much this disease is affecting your quality of life. If the pain and immobility returns within a year and your current treatment options stop working, we’ll try inducing menopause.
Lupron has its risks, but it allows us to achieve valuable steps both in terms of symptoms and diagnosis. You’ll get an injection every three months. When you decide you want to try pregnancy or want to stop the course of treatment, you’ll stop the shots and return to your natural hormone cycle. The effects of this shot are reversible. If you do have endometriosis, Lupron will relieve all your symptoms. We’ll also know for certain that this is endometriosis. If you still experience pelvic pain and cramping while using Lupron, you don’t have endometriosis. The side effects may be intense, but it’s something to consider if you get worse over the next few decades.”

I told her I was worried about the surgery itself. It’s a very common diagnostic procedure; it’s minor surgery and thousands of women undergo it every year. However, a close relative of mine underwent a diagnostic laparoscopy in her early twenties for endometriosis and her doctors decided to give her a hysterectomy. Obviously, her health history was somewhat different and it was medically necessary. Still, it’s hard to sign up for a small procedure if you could wake up without one or both ovaries or all your reproductive organs.

She asked me when this happened. It was the 1970s. She leaned forward and said, “That was a very long time ago, and medicine has come a long way since then. The biggest difference is that there were no female surgeons and very little research on the risks of hysterectomies on very young women. We’re not going to remove any of your organs, no matter how bad the extent of your endometrial implants. You’re much too young, and your imaging shows no tumors or large cysts. There’s no reason to put you through that. You may decide you want to have children later in life, but that’s not the main motivation for keeping your organs. Where do your hormones come from?”

“My ovaries.”

“Yes, and they’re very important to your overall health. You need to keep them. If you were 50 and approaching menopause, we’d be having a different conversation. I want you to write down any questions you may have, but I don’t want you to be concerned with keeping your organs.”

We then went over what a laparoscopy is. I’ll be put under anesthesia and my abdomen will be inflated through my navel. The surgeon will insert an instrument to manipulate my uterus. She will then insert a very small camera through my navel and a cauterizing tool. If she finds evidence of endometriosis, she will use the cauterizing tool to ablate, or burn away, the endometrial tissue. I thought this would take hours. She said it should only take a very short time; the large time frame for the surgery is to regulate my sedation and anesthesia. After the ablation, my abdomen will be deflated and they will move me to recover from the anesthesia. I’ll go home the same day.

In another week, I’ll have one more pre-operative appointment where I can discuss some of the questions raised from responses on this site and register with the hospital where the surgery will be performed. I’m anxious, but I’ve done some research and feel comfortable with my choice of surgeon. With any luck, I’ll have a diagnosis and a treatment plan within another month.

Please note, Lupron can neither diagnose nor confirm endometriosis. Lupron was never approved for such uses. For more information, please click here: Lupron.

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Is it Endometriosis?

by R S

Published on May 9, 2013

6934 views

I probably have endometriosis, but there’s only one real way to be sure: a laparoscopy. In a few weeks, I will undergo this minor surgical procedure and finally get a diagnosis for the disease I most likely have.

The symptoms started in late November: a strong gnawing pain in my lower right abdomen that worsened over a week. I could stand up, but not walk normally. When I went to my primary care doctor, he sent me to the ER. There, they performed a CT scan and a trans-vaginal ultrasound. All they found was excess fluid. “It’s a ruptured ovarian cyst,” the ER doc said. “It’s very common in women in their mid- to late twenties. Just rest for three days, take some NSAIDs, and see your gynecologist.”

My gyno did a pelvic exam and found that I was tender and sore over my right ovary and in terrible pain when he pressed on my left ovary. Not only that, but the ligaments near the back of my uterus were tender too. He asked me a very long list of questions that I was surprised to hear. “Have your periods been getting more painful? Has intercourse become more painful? What has your menstrual health looked like over the past six months? Has anyone in your family been diagnosed with endometriosis?”

I answered that my periods had recently become irregular and more painful, but nothing too unusual. I thought that intercourse had been normal, but my partner chipped in: “No, actually, there have been times when intercourse has been very painful for you.” I had simply dismissed it as I’d read that hormonal fluctuations are normal as you near 30, and that your periods generally become heavier and sometimes more painful. My gyno told me that this is called “normalizing behavior”: because something out of the ordinary doesn’t strike us as a medical problem, we simply dismiss it and forget it even happened, much less associate it with illness. Also, members of my family did have endometriosis.

He told me I’d have to have a CT scan done to check for ovarian cysts, and that we had to rule out polycystic ovarian syndrome and pelvic inflammatory disease, but it was likely I’d developed endometriosis later than usual. He prescribed a course of progestin to reduce the swelling of the scar tissue and adhesions and then told me to start extended-cycle birth control (where you only menstruate every three months).

I was hoping to have a quick diagnosis and be back to normal in a few weeks, but it turned out to be anything but short and simple to find a diagnosis and a treatment plan.

Progestin was very hard on me physically and emotionally. I vomited constantly, even waking up in the middle of the night to do so. I grew a stringy white beard and a brown mustache (these fell out when I stopped the medication). I found myself sobbing at cat food commercials and songs I previously enjoyed. I started feeling very cold and very warm at random intervals, and thought that my partner was messing with the thermostat. These, apparently, are the joys of hot flashes. I got vertigo and found myself stumbling dizzily to the kitchen or bathroom. With each dose, I became more emotionally weird. It was a short course of hormone replacement therapy, and it did in fact reduce the pelvic pain, but I’m terrified to ever experience that kind of emotional instability again.

I started the extended-course birth control and felt better each day that progestin left my system. There were new symptoms, though, and they continued to worsen over the next three months. I felt a strange tugging sensation in the front of my pelvis when I would bend over. It’s hard to describe, but it reached a point where I couldn’t bend over to take out the trash or put on shoes. It became horrifyingly painful to use the restroom in any way. My abdomen swelled, not too much, but enough that sweatpants and pajamas were my only option for pants. I was horribly constipated, probably because going to the bathroom hurt so much that I’d stopped eating normally.

Within two weeks, I couldn’t stand or walk without assistance. Everything between my ribs and upper thighs was a mass of cramping pain. I was hoping that the birth control would reduce what was possibly endometrial tissue enough that I could walk, but one night I was in so much intense pain, now on the left side, that I begged my partner to take me to the hospital. “Something feels like it’s going to burst,” I said. I had a fever and diarrhea and a stabbing pain on the left side. The CT came back perfectly normal. The ER doc said, “There’s nothing seriously wrong with you. You probably just have a bit of stomach flu, but see a gastroenterologist just in case.”

All in all, I’ve had two CT scans without contrast, two CT scans with contrast, five rounds of blood tests, one stool sample, two trans-vaginal ultrasounds, two ER visits, six specialist visits, and a colonoscopy. The specialists ruled out polycystic ovarian syndrome, liver or gallbladder problems, diverticulitis, chronic appendicitis, cancer, and mononucleosis. Everything came back normal except for the colonoscopy, and I’m currently waiting for the diagnostic laparoscopy.

I’ve been very lucky to have specialists that took my complaints very seriously. After three months with every test returning normal, I was starting to feel like it might all be in my head. All the tests come back normal, but I’m in horrible pain! I can’t even stand up by myself anymore! There has to be something in there, why can’t they find it? What if they think I’m just seeking painkillers? They have to know that I’m not making it up! And, most of all: Why is this taking so long? I’ve been sick for three months, and I seem to be getting worse. I can’t take another day of this pain.

My gastroenterologist thought I might have diverticulitis and put me on antibiotics and a liquid diet. He scheduled a CT with contrast. The scan came back normal, but the liquid diet really did help with the bowel pain. He then wanted to rule out chronic appendicitis and put me on a very strict diet with regular use of laxatives and scheduled a colonoscopy. At that point, I had a very swollen abdomen, would cry when anyone pressed upon it, had mucus in my stool, and had strong cramps throughout my abdomen and pelvis when I was full. I was starting to lose control over my bowel movements. I still couldn’t walk or stand on my own.

They did an exam moments before the colonoscopy and told me I might need my appendix removed or a colon resection. There was a chance I would wake up in a hospital, but not to worry. They had done this procedure many times, and I was in good hands. I went under the anesthesia utterly terrified.

When I woke up, they told me they had found a large growth in my colon. They had sent a tissue sample out for a biopsy which would return in around three weeks, but not to worry. My appendix was fine. I had no infection or abscesses. Just take it easy and drink a lot of fluids.

Two weeks later, the biopsy returned. The colon growth was completely benign, and they had cauterized its blood supply during the colonoscopy. It would wither and pass all on its own. My gastroenterologist said it might grow back, but not to worry. He’s fairly convinced, although we have to wait for the laparoscopy, that the growth is the result of endometrial implants and scar tissue putting pressure on my colon. He’s fairly sure that the laparoscopy will show that I have advanced endometriosis, and the implants and scar tissue have spread very far up my abdominal cavity, causing irritable bowel disease and the colon growth. He told me to follow a special diet, take laxatives as prescribed, drink plenty of fluids and above all, to calm down. Breathe. Relax. Know that I have good doctors and I will be OK.

I’ve discovered a few things along this bumpy diagnostic road. I’m allergic to all painkillers, so other pain solutions and stress management are vital. Warm baths, walking even though it hurts, and eating a vegan diet with lots of water and laxatives as prescribed are very important. I’ve been encouraged by my doctor to apply for medical marijuana use, but that’s a whole other story.

Stress reduction is the most important factor in my life right now. The pain and uncertainty of being diagnosed with this disease are very hard to experience, and also hard on family, friends, and romantic partners. Find music you think is soothing. Make sure you have some time in a park or near plant or animal life. Try meditation or yogic breathing if that’s something you’d like to do. Surround yourself with books and TV that make you laugh. If anyone treats you badly, blames you for the disease or pulls away, that’s their choice, and it doesn’t mean it’s your fault. Some people react poorly when confronted with illness, and that’s their problem, not yours.

It is so important to research your doctors and specialists before you make appointments. Make sure they have no citations for malpractice and that they’re certified to do the surgical procedures you need. If your primary care doctor or specialist minimizes or dismisses your symptoms, or simply tells you they don’t know what to do with you, find another doctor immediately. Keep a journal of your symptoms. They might change on a dime! There are many applications out there besides pen and paper to track your reproductive health and endometriosis symptoms.

I have lost nearly 30 pounds, but I can walk again now that the colon growth is gone. Sometimes I can drive, which is fantastic after four months of being stuck in bed. As long as I follow the vegan diet my gastroenterologist put me on and take laxatives as prescribed, my digestive health is more or less back to normal. The extended-cycle birth control has made my life a lot easier as well.

There are days when I can go grocery shopping, drive myself around, eat three good meals, and go for long walks. There are other days when I need to stop what I’m doing and rest because of pelvic pain. There have been a few days when I’ve vomited frequently and couldn’t sit or stand at all due to pain, and it’s back to bed for me.

I have so many questions now, but it’s a great relief to see the end in sight. After the laparoscopy, we will know for certain if I do have endometriosis. It runs in my family, and it seems the most likely culprit. My greatest fear is that they will find nothing, but I hope that won’t be the case.

Thoughts that keep me awake at night: What if the intense pain comes back? What if I become bedridden again? What happens when I’m 35 and have to stop the birth control? What will my sex life be like? Will my partner still find me desirable and worth the effort if I’m sick on and off until menopause? What if the bowel disease and growths come back? How will I find an employer that is understanding of this condition, of how I may have to take 2 or 3 days off every month if I’m in too much pain to stand or drive?

Those questions don’t really matter in the long run. Being anxious and scared is normal after all these changes to my body and life. Researching this disease and finding treatment options and coping mechanisms is of great importance. Building a support network of friends and people who know what I’m going through also matters. Finding doctors I trust and can work with matters. I don’t expect anyone else with this disease to say, “That’s exactly what happened to me!” Endometriosis affects every woman differently. Symptoms can differ wildly from person to person. Accepting my body, no matter how much pain it’s put me through, is also important. I’m still worthy of love and friendship, and my goals are still possible, I just have to shift my perspective a bit.

Dietary Spring Cleaning: Tis the Season to Eliminate Red Meat

by Jordan Davidson

Published on May 6, 2013

2319 views

To come out and say that one should eliminate all red meat from their diet might sound rash; a part of some great overly zealous vegetarian (down with the man, up with the green juice, etc…). However, any and all ulterior motives aside, red meat is not good for you and that’s phrasing it nicely.

A study from Harvard published in the Archives of Internal Medicine (2012) found that red meat is associated with an increased risk of Cardiovascular Disease and cancer related deaths. The study also found that switching to other healthy protein options helps lower CVD and cancer risks (fish by 7%, poultry 14%, nuts 19%, legumes 10%, low-fat dairy products 10% and whole grains by 14%). Based on the research it was estimated that 9.3% of deaths in men and 7.6% in women could have been prevented if all the participants had consumed less than 0.5 servings per day of red meat.

A serving size of red meat is considered to be about 3oz, which would make half a serving size 1.5 oz. Not sure what 3oz of red meat looks like? It’s about the size of your standard deck of playing cards. So if you are trying to eat heart (and body) healthy – I hope you have the appetite of Tiny Tim – otherwise 1.5oz of red meat might not cut it for you. However, many dietitians recommend for optimal health that you try and eat no more than 4oz of red meat per week. It should also be noted that the type of red meat you eat also plays a role in your risk. A daily, 3oz serving of unprocessed red meat was associated with a 13% increased risk of mortality, while a daily serving of processed red meat (one hot dog or two slices of bacon) was as associated with a 20% increased risk of mortality.

Part of the reason red meat is so detrimental is because it contains large amounts of saturated fats and cholesterol. Lean red meat does contain a lot less cholesterol and saturated fats than red meat however, it has cancer causing compounds that form when cooked at high temperatures. And of course don’t forget your processed meats (hot dogs anyone?) which are chock full of nitrates, saturated fats, cholesterol and sodium. 6 slices of bacon a day (9 oz) can increase your mortality rate by 60%. This is why the American Institute of Cancer Research suggests not eating processed meat at all.

While red meat isn’t good for anyone, especially those with hypertension, high cholesterol, heart disease, or a family history of any or all of those problems, red meat is also bad for those with chronic inflammation and women with pelvic problems such as endometriosis. A study conducted in Milan published in the Journal of Human Reproduction (2004) found that women who ate red meat on a daily basis were 80 -100 times more likely to have endometriosis.

Red meat contains prostaglandins, as do our bodies. Prostaglandins are hormone messengers that relay pain messages. There are good prostaglandins and bad ones. The bad ones rely hormone signals which lead to inflammation, blood clotting, fever and pain. Despite the ‘bad’ connotation these are necessary because they alert our bodies to problems. If you had a serious infection without a fever, you might not know and then you wouldn’t be able to treat it. For women with endometriosis excess prostaglandins are bad because they can attribute to more pain and inflammation. Red meat contains these prostaglandins and is believed to therefore increase pelvic inflammation and pain.

This spring clean out your internal closet and make a resolution to treat your body better. The best way to stay healthy is to make healthy choices in your every day life and there is no easier way to do that, than by making smart decisions about the food you eat.

Jordan Davidson is a Freelance Health and Nutrition Writer based out of New York City. She is also the proud parent of a new blog Hersterical – Healthy Living for the Less Healthy. You can contact her with any inquiries at hersterical@gmail.com. You can also follow her on twitter at: @JA_Davids.

Angela’s Endometriosis Post Operative Update

by Angela Wice

Published on March 21, 2013

2850 views

It has been two weeks since my endometriosis surgery and I feel better mentally, physically and emotionally. The surgeon was supposed to remove my left ovary and both tubes and a possible hysterectomy if there were complications. Remember, in my last post I begged for a hysterectomy to stop the pain. She didn’t do the hysterectomy, remove the ovary or tubes. Here is what happened.

In Post Op

When I woke up, I was curious as to what they found. I wanted to know if the hormone pills worked for the last seven years; if they had kept my endometriosis at bay. I also wanted to know if there was a bowel obstruction because then I wouldn’t feel crazy. I was doing enemas three times a week for the last three years because I couldn’t go. I wanted to know if there were adhesions on my bladder and ureters as I was having serious issues in that department including peeing myself because I had no sensation to go. I pretty much knew that bowel was stuck to my ovary on the left side and the ovary was also stuck to the uterus causing sex to be so painful.

There were complications. I didn’t have the hysterectomy as intended. The doctor didn’t take my tubes or left ovary. My right ovary was embedded into the pelvic floor which she did not detach as she told me it was “really, really, really stuck”. I had a lot of adhesions which were causing the bowel obstruction just like I suspected. I also had adhesions on both my ureters and bladder. My left ovary was stuck to uterus and bowels and the uterus was stuck to the colon. That was set free. She found only superficial endometriosis. This means that either all the injections and various pills I had been taking all this time somehow worked or it was the adhesions from the previous surgeries that were causing all of the pain.

As I lay in post op, as I have before many times, I asked the surgeon’s assistant for the details of my surgery; what to expect over the next couple of weeks. The surgeon was too busy to bother. Her assistant wasn’t very helpful either. I thought about all the women that have surgery for endometriosis and how helpless they feel afterwards. The doctors really don’t tell the patient anything – mine didn’t. (I’ll be posting an article about doctor etiquette next week). So I asked “Do I keep taking the pill continuously?”, “Why wasn’t the ovary detached?” Why was nothing taken as we discussed?” I learned nothing. Even with the phone call to the surgeon a week later. I guess I have to wait until our follow up appointment on April 15.

Recovery

Right now my bowels have been somewhat great. I am going every day or every other day. It did take a while after surgery. That made me nervous, but I seem to be doing okay now. I have random bowel pains but I suppose that could be the healing process.

With my bladder there was a 60% change. I am no longer peeing myself. I no longer have the urethral pain I was having or spasms and I am not nearly going as much as I was prior to surgery. However I am still going at least 15-20 times a day not 40+. I am still happy with this. It was really controlling my life and I couldn’t go anywhere. It was frustrating. Now at least it’s a little better.

I still have to wait to have sex so I am not sure how that is going to feel and in a way I am anticipating it. I am also nervous and scared that it won’t change a thing.

The healing process itself was very quick. My first surgery was extensive with deep pelvic floor dissection and had some complications with my bladder, but this time I was good. I could pee right away which was a great sign. The pain was not nearly intense as the last time. I was pretty much ready to go back to work in three days, whereas last time I wasn’t even okay after two weeks.

All in all, my recovery is going well. I am anxious to learn what the doctor found and what my prognosis is. I will keep you posted.

A New March Madness – Endometriosis Awareness Month

by Jordan Davidson

Published on March 4, 2013

2635 views

This March I am celebrating a different kind of madness. It has nothing to do with college basketball; nor is it related to four leaf clovers, egg shaped candy or seder plates. No, this March is for reproductive health education and raising awareness about endometriosis. There is nothing nice about endometriosis, even the word is cumbersome to say. This March, we need to talk about endometriosis and reproductive health and we are going to talk about it; because the state of reproductive care surrounding endometriosis is not OK and it’s not going to get better until more people know about endometriosis and the facts surrounding it.

It is estimated that 1 out of every 10 women has endometriosis. Endometriosis is a secondary autoimmune disease that occurs when the endometrium (the lining of the uterus) grows outside of the uterus. Common places for this tissue growth is outside of the uterus, on the fallopian tubes, ovaries, bladder, within the pelvic cavity, on the pelvic floor, and on the bowels. In extremely rare cases endometriosis can be found growing up towards and on the liver, lungs, brain and on the central nervous system. These growths respond to the menstrual cycle the same way that the lining of the uterus does. Each month, the lining builds up, breaks down and then sheds (aka ‘your period’).

When a woman gets her period the broken down lining exits the body as menstrual blood through the vagina. When a woman has endometriosis, the tissue and blood from the endometrial growths found outside of the uterus have no way of leaving the body. This results in internal bleeding and inflammation; both of which can cause chronic pain, infertility, scar tissue formation, adhesions and bladder and bowel complications. Women with endometriosis also suffer from higher rates of allergies, yeast infections, asthma, chronic fatigue, fibromyalgia, other autoimmune diseases (such as hypothyroidism and lupus and others) and increased rates of ovarian cancer, non-Hodgkin’s lymphoma and brain cancer.

There is no cure for endometriosis and treatments leave a lot to be desired. Common treatments include oral contraceptives, GnRH agonists, progesterone therapies, surgery and hysterectomy. Since endometriosis usually appears during the reproductive years, hysterectomy is not a welcomed option and yet is commonly prescribed. Surgery does not cure endometriosis, in many cases the growths reappear within five years. Hysterectomy does not cure endometriosis, with 40% of women see a reoccurrence of their symptoms. There is no cure for endometriosis.

This March we need to raise awareness. It’s not a comfortable topic but that is no reason for millions of women to suffer in silence with no known cure. The discomfort society feels in talking openly about menstruation or uteri or vaginas is no reason to deny any woman the right to proper reproductive care. 1 in 10 women have endometriosis. These women are your friends, neighbors, sisters, co-workers, lovers, girlfriends, cousins, aunts, nieces, mothers, and fellow humans. It takes an average of 7 years to get a proper diagnosis and even longer to find an effective treatment plan (if any). This is about proper reproductive care, about millions of women who are embarrassed to talk about painful periods, about millions of women who suffer in silence. It needs to stop.

This is not a call to arms but a call to uterus(es). This month lets promote reproductive care and raise awareness for endometriosis. Ask me about my uterus, ask those you care about, about their uterus. Yes, it sounds strange, but how else are we to start the discussion and break the stigma against talking about reproductive illness; especially if we can’t even say uterus or vagina without snickering or feeling as embarrassed as a third grader would. Please help us raise awareness this March; share this article, share your story, start a conversation, ask a loved one about their uterus and break the silence!

Endometriosis in Teenagers

by Center for Endometriosis Care

Published on March 1, 2013

2693 views

The endometriosis patient who elicits from me the greatest form of empathy and compassion is the patient whose pain begins in her teenaged years or even earlier. This young woman has doubts and fears when she thinks her incapacitating symptoms are the norm. She believes that everyone feels as bad as she does during her period (or apart from menses, if her symptoms are not confined to her periods), and so she concludes that other girls handle things better.

She starts to wonder, “Am I a wimp? Do I have to live like this for the rest of my life?”

These feelings of inadequacy are deepened by often well-meaning but uninformed people including coaches (“Working out will make your cramps better”), parents (“Your sisters never complained like you do about this”), and girlfriends (“Don’t be such a baby! It’s just your period!”). Many times the afflicted teenager grits her teeth and tries to tough it out.

When her symptoms do not improve, or when they worsen, the teenager may finally be taken to a doctor, where she may experience her very first pelvic exam. If this examination is not very carefully performed, the experience can be both humiliating and painful. After the exam, the patient may be told, “Everything appears normal.” The message is, “There’s nothing wrong with you. Why do you complain so much?”

If her symptoms are felt to be severe enough, the teenager may be initiated into the world of analgesics (pain medications). Repeated visits to the physician may result in numerous different analgesics.

If symptoms persist, the patient is given ovarian suppressants in the form of birth control pills. The result is that an otherwise healthy and normal young woman is now functioning only with the help of her drugs.

Our society in general frowns on drugs, and teenagers today have especially been inundated with the message, “Just Say No!” This concept contrasts with the young woman’s drug dependency (not drug addiction) and can contribute to a gradual loss of self esteem.

She may think, “I shouldn’t take drugs, but I can’t function without them, therefore I am weak or helpless or worthless or bad.”

As endometriosis progresses in these young women, most eventually end up on the operating table for diagnostic procedures. The endometriosis is diagnosed (sometimes) and staged (sometimes). If the physician believes that there is no cure for this devastating disease, he or she may offer only analgesics or medical forms of therapy (Danocrine, Lupron, Synarel or Zoladex) which stabilize the process at great monetary expense and side effects that can be as bad as the disease itself.

The ultimate result here is that, in addition to all the other physical and psychological impacts of this type of treatment, it takes away the teenager’s hope that she will ever be pain-free to live a normal life. There is nothing I know that has a greater impact on our lives than the loss of hope. It is a primary form of torture used on prisoners of war. Is it any wonder that we find many of these young women have become angry, depressed, and totally confused?

What Can Be Done?

Thankfully, we have much to offer a young woman with endometriosis.

Make the Diagnosis Early

Young women who do not respond to simple mild analgesics and who have any suggestive findings on physical examination should be laparoscoped. Endometriosis should be considered as a possible diagnosis at any point after a girl has her first period (menarche).

Don’t be Drug-happy

If she has symptoms consistent with a diagnosis of endometriosis, it is crucial that the diagnosis be proved before subjecting a young woman to prolonged bouts of powerful drugs. Sometimes physical abnormalities can cause painful symptoms. Such abnormalities can be corrected surgically and are not helped at all by medications.

Believe the Patient

A young woman’s support group (parents, siblings, schoolmates, teachers, partners, boyfriends and girlfriends, etc.) should believe her when she reports pain and other symptoms. It is really very unusual for a well adjusted child to suddenly begin using complaints of pain to get attention.

Enlist an Expert

Facing a first pelvic examination is a little intimidating for even the most relaxed woman. Imagine, then, how frightening it can be for a young woman, in pain and worried. Find a physician who is interested in treating the entire person: not just a collection of pelvic organs.

Know These Facts!

We are now finding that well-trained surgeons skilled in recognizing all visual manifestations of endometriosis can keep recurrence rates under 20% by completely excising all disease. In the overwhelming majority of cases, surgeons knowledgeable in advanced laparoscopic techniques do not need to make large incisions during surgery. Most patients go home the same day they have surgery.

Certainly, menstrual cramps may persist, and some women will have pain around ovulation. Overall, though, I have found the ability to relieve the pain of endometriosis sufferers is one of the most gratifying things I have ever done.

When chronic pain is relieved, you will see the return of a healthy state of mind. These young women can resume their lives as they ought to be. One young woman’s parents wrote, “Thanks for giving us our daughter back.”

We think the teen-aged years are hard enough without endometriosis making them worse, and are pleased to be able to offer the opportunity for significant and long-lasting pain relief.

About the author: Robert B. Albee, MD, FACOG, ACGE is the Founder of the Center for Endometriosis Care, a COEMIG-designated center of excellence in the treatment of the disease.

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Resveratrol from Red Grapes Blocks Endometriosis

by Chandler Marrs, PhD

Published on February 27, 2013

5143 views

A new study out of Germany found that resveratrol, the popular phytochemical derived from the skins of red grapes, known for its anti-inflammatory and anti-oxidant benefits may also have potent anti-angiogenic properties that inhibit the growth of endometriotic lesions.

How it Works

The infiltration and survival of endometriotic lesion requires ample blood supply. This requires new blood vessels to supply the endometriotic tissue with vital nutrients and growth factors. Without those blood vessels, the tissue dies. Angiogenesis is the process by which new blood vessels are born. A compound that is anti-angiogenic blocks the birth or growth of new blood vessels, effectively starving the lesion or the tumor. Blocking angiogenesis is a popular mode of treatment for cancer, but has not been fully investigated in endometriosis.

In a mouse model of endometriosis (uterine tissue is surgically implanted in the mouse abdomen and allowed to grow), researchers tested whether resveratrol would block angiogenesis. It did. Mice fed 40 milligrams of resveratrol per kilogram of body weight per day of resveratrol had significantly less vascularization and smaller endometriotic lesions than did the control group.

Bottom Line

Will drinking resveratrol inhibit the growth human endometriosis? It’s too early to tell, but an emerging body of research is showing remarkable results with resveratrol and cancer in human and animal studies. More research is needed to determine its role in endometriosis and the appropriate dosing strategies. The nutritional supplements currently on the market may not have the concentration or purity of resveratrol used in the lab study. Just for reference, neither does red wine. This study was short, only four weeks, and of course, extrapolating from mice to humans is always problematic. The research is promising, however, and points to a new direction in endometriosis research – one that includes dietary changes.

Wish Me Well – Hysterectomy Looming

by Angela Wice

Published on February 26, 2013

1976 views

As I embark on my surgery in a couple of days, I have come to terms with the fact that I could possibly wake up with the hysterectomy I have wanted for 5 years. I will not know for sure if the doctor will do the hysterectomy, as she is not willing to do the procedure unless there are complications. Is it bad to wish for complications? I want it all out. I have weighed the pros and cons. I know the hysterectomy provides only a 50/50 chance of getting better, but I am done with this disease. Fifteen years of suffering with endometriosis is enough.

I am afraid of what will happen to my hormones after the hysterectomy. I am not quite prepared for the wrath of raging hormones. Maybe I will just wake up with the tubes and left ovary gone. Maybe I am not yet facing the reality of what may come. I have begged and pleaded for a hysterectomy for so many years, but for some reason they would not do it. My doctor wants to try removing my tubes first and my left ovary to see what happens. I guess she is right. I should try this surgery one more time because my first surgery was so successful, in 2007. If it wasn’t for the post-surgery pelvic inflammatory disease that wreaked havoc on my insides, maybe I would be feeling better now.

I just don’t want to have another surgery after this. After this I am done and that is why deep inside I hope she removes everything.

This is a difficult decision to make, probably just as difficult as having to pull the plug on someone you know is not going to make it. You sit there with that thought in your mind “What if?” It is one of the most serious decisions of my life. I can’t take it back if it all goes wrong. I have to live with it.

The truth is, all the side effects don’t matter to me right now at all. I don’t want my woman parts anymore. I don’t want to have to go back and forth for all the tests only to end in tears and to be rejected my doctors who show no empathy when it comes to the survival of this disease. This choice is my decision to make mine and mine alone. I have listened to so many people and read so many stories but, in the end, I am sick of the cycle, sick of this disease, sick of the drugs, and just sick and tired of being sick and tired.

If she does not remove everything and I have no relief after this surgery, I will be looking for a surgeon that will remove it. I am 100% sure about this. I wasn’t sure before.

Thank you everyone who posted their thoughts, encouragement and concerns. I took them all in and made my decision. I just needed to be at peace with it. I am now. Wish me well. I will post again after the surgery.

My surgery is scheduled for February 28^th.

Hormones Matter

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