COMPLETE ENDOMETRIOSIS TREATMENT

Endometriosis has a very high recurrence rate. Unless a woman menopauses , she is not free from the disease. Endometriosis has a potential to recur as long as there is still menstruation. Even after removal of the uterus by surgery, if there are still female hormones, either from the ovaries that are not removed or hormone replacement therapy for menopause, endometriosis has a potential to recur. That is why a complete and holistic treatment program is needed.

1. Early detection of disease

The earlier we detect, the less the disease bulk, the easier for treatment and the less the recurrence. This is simple logic. But, there are hurdles to this because: Invisible disease – Routine ultrasound scans have failed to detect the disease. Many women with endometriosis need 5 to 10 years of pain before she gets her final diagnosis of endometriosis. With Deep Endometriosis Scan, early diagnosis can be made but this is a very specialised scan and only done by trained hands. Because this scan is not easily available, endometriosis remains as an invisible disease.

“Menstrual pain is normal”

Women grew up accepting that period pain is normal. Endometriosis affects 20 to 30% of women. Therefore, every woman with endometriosis is surrounded by many other women with similar symptoms and that reinforce their perception that period pain is normal, that diarrhoea during period is normal, that backaches during period is normal, that ovulation pain is normal. But, in actual fact, these are all symptoms of endometriosis.

2. Complete Surgical Removal of Disease

There are 2 types of surgical options for endometriosis. Ablation or excision. Ablation is a commoner option but it does not remove the disease and has a high recurrence rate. When you ablate an endometriosis nodule, you only ablate the most superficial layer of the endometriosis. The deeper endometriosis will still be present and will eventually surface.

With excision, total removal of the disease can be performed via robotic-assisted laparoscopic, ideally, or laparoscopic surgery without robotic-assistance. Unfortunately, it is a very complicated surgery and only done by a very specialised gynaecologist. And because it is not widely done, most women do not get an excision surgery.

ENDOMETRIOSIS: TWO TYPES OF SURGERY

3. Long term medical therapy

Even after 100% removal of endometriosis, period backflow can recur and as long as a woman is still menstruating, endometriosis can recur. Every woman with endometriosis needs to have a long term prevention plan. This is tailored to each and every woman depending on her age, her severity of the disease and her needs to conceive.