• Highlights
• Introduction
• Causes
• Symptoms
• Risk Factors
• Complications
• Diagnosis
• Treatment
• Lifestyle Changes
• Medications
• Conservative Surgery
• Hysterectomy
• Resources
• References

Endometriosis

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of endometriosis

Alternative Names

Hysterectomy and endometriosis

Highlights

Drug Research

• Low-dose progestin therapy works as well as gonadotropin releasing hormone (GnRH) agonist drugs in relieving endometriosis pain. Progestin therapy also causes less loss of bone mass and fewer hot flashes than a GnRH agonist. However, women who take progestin may have more bleeding and spotting.
• A progestin-releasing intrauterine device works as well as GnRH agonist drugs in managing pain and causes less loss of estrogen. Some experts now recommend the levonorgestrel-releasing intrauterine system, LNG-IUS (Mirena), as a first-line treatment for women with endometriosis who do not wish to become pregnant.
• GnRH agonists may help women with endometriosis become pregnant when they are given along with infertility treatments such as in vitro fertilization. A 2006 review reported that GnRH agonist drugs quadrupled pregnancy rates when combined with infertility treatment. However, the review did not report how many women actually gave birth or what effect the drugs had on the mother or fetus.

Surgery

Women who have their uterus surgically removed (hysterectomy) may experience fewer hot flashes than women who enter menopause naturally. However, women who have both ovaries removed (bilateral oopherectomy) and who do not take hormone replacement therapy may have more severe hot flashes compared with women who have a natural menopause.

Risk Factors

• A thin body type may be associated with endometriosis and a heavier body type may protect against it. Women who are diagnosed with endometriosis tend to have a lower body mass index (BMI). They also tend to have had a leaner physique during their adolescent and young adult years.
• Migraine may be associated with endometriosis, according to a study in Headache . The small study found higher rates of endometriosis and heavy menstrual bleeding among women who suffered from migraine headaches.

• Review Date: 6/13/2006
• Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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