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Doctors Lounge - Gynecology Answers
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| shellymae
- Mon May 04, 2009 9:33 am |
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I had 3 previous surgeries for endometriosis and endometrioma. My last one was 3 years ago. I have stage 4 severe endo. It was all over including bladder,liver,intestines and other areas. I keep getting endometrioma on my left ovary. Each time I have endometrioma they are bigger than before and required to be removed. I am starting to have problems with my ovary again and went for ultrasound for possible endometrioma again. I been on birth control since I was diagnosed with endometriosis 9 years ago. How do I prevent myself for getting endometrioma? Should I consider trying Lupron again? Can Mirena help? I don't have children yet and not ready to have children at this time. I am busy persuing my degree right now. I only get the pain during my period and its not the normal cramps that everyone gets. Should I consider going in for my fourth surgery or can medication work better?
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| Debbie Miller, RN
- Sun May 24, 2009 12:10 am |
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 Hello,
It would be impossible to say which will be your best course of action at this point. Both medications and surgery are used and sometimes it is a matter of trial and error, experimenting with one drug or another until you get relief. Sometimes the decision is made regarding fertility issues. Since infertility is a common problem with endometriosis, surgery is sometimes done prior to attempting conception. If the symptoms can be controlled without the surgery, you may choose to wait for that until you are contemplating a pregnancy.
I am not aware of Mirena being used to treat this condition, though it does incorporate hormones so it may have some effect. The hormones typically used include Gonadotropin-releasing hormone analogs, oral contraceptives such as you have used, progestins, Danazol (which creates higher male-type hormones and lower estrogen levels, but not without side effects), Gonadotropin-releasing hormone analogs (GnRH analogs) which interrupt estrogen formation within the endometrial implants.
You certainly have nothing to lose by trying alternative non-surgical treatments first. As you know, even after surgery, recurrence is common.
Good luck and best wishes.
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