Stolen Laptop Returned...Medical Treatment of Endometriosis
Posted Sep 25 2009 3:34pm
Hello again to all those (including my Mother) who were wondering where I have been and what I have been doing. The answer is pretty much working and trying to keep up with a number of projects that drain my energy and time. A pretty lame excuse, I know, but it is the truth.
Here is a housekeeping point. I usually fail to respond to posts on this blog as quickly as I respond to posts on the INCIID website. Shame on me but just remember that free advice is worth what you pay for it..
For those who have read this blog since last summer here is an update on the great stolen laptop trauma….I now have it back in my possession. The guy who sold it to the pawn shop was let off as there was no physical evidence linking him to the act of stealing the laptop: “I was just walking down the street when suddenly this MacBook Pro fell out of the sky and almost killed me…so I immediately took it to a pawn shop.” Oh well, that’s the way it goes. So in any case I have it back. Unfortunately, all of my family photos were deleted and my iPhoto application was filled with downloaded photos of Beyonce (without many clothes covering her ample assets) and additional other photos from www.bigbooty.com…not a site that I regularly visit as I explained to my wife.
So picking up where we were last time… we were discussing endometriosis and the impact of endometriomas on IVF success. Not all endometriosis treatment is surgical but if the goal is fertility then medical treatment makes little sense as all of the medical treatments prevent ovulation and therefore, prevent pregnancy. Here is the Question of the Day (?week, ?month) from the book that all of you lurking out there have yet to review on Amazon.com…100 Questions & Answers about Infertility.
38. Are there medical treatments for endometriosis?
Several medications exist to treat endometriosis. All of them are designed to suppress the endometriotic implants by sup- pressing ovulation and causing a hypoestrogenic state. Unfortunately, suppressing ovulation also prevents pregnancy from occurring. In patients who are not trying to conceive, medical treatment of endometriosis can be very beneficial and relieve symptoms of dysmenorrhea and pelvic pain.
One common medical treatment involves oral contraceptive pills taken on a daily basis. Although each of these pills contains estrogen, the progestin (progesterone-like component) in the pill overrides the estrogen effect, resulting in suppression of the endometriotic lesions. Oral contraceptive pills are effective in 30% to 60% of patients with endometriosis-related pain.
Many physicians prescribe gonadotropin-releasing hormone (GnRH) analogs (such as Lupron), which reduce estrogen levels to postmenopausal levels for their patients with endometriosis. These medications suppress estrogen production, prevent ovulation, and cause atrophy of the endometriosis in 70% to 90% patients.
Unfortunately, GnRH analogs are expensive and must be given as injections either once a month or every 3 months. GnRH agonists can cause side effects including headaches, hot flashes, moodiness, insomnia, and vaginal dryness. To counteract these problems, physicians often prescribe oral contraceptive pills or supplemental progestin therapy such as norethindrone along with the GnRH analogs. This combined therapy has many advantages, including improved treatment acceptance and alleviation of the many side effects associated with the use of the GnRH analogs as single therapy. Patients tolerate this combination very well and achieve maximal benefits in suppressing the disease and its symptoms.
For patients with endometriosis who are actively trying to conceive,medical therapy is not indicated, because all of these treatments will suppress ovulation. Instead, for these patients, the goal should be to promptly establish pregnancy before the endometriosis causes any further damage to the reproductive organs. Generally, these women should seek treatment from a fertility expert to maximize their chances for successful pregnancy.