Medical treatments are divided into hormonal and non-hormonal treatments. There are a number of hormonal treatments currently available, which may involve one or a combination of hormones. They are directed at controlling growth of endometriosis, preventing recurrence after it has been removed at surgery, or controlling the menstrual cycle to reduce pain. Non-hormonal medications include pain-relieving medications such as paracetamol, non-steroidal anti-inflammatories (such as Neurofen) and strong pain relievers. These medications are designed to relieve the pain that can be associated with endometriosis, though they are not intended to reduce the amount of endometriosis present.
Surgical treatments are aimed at removing endometriosis and cutting adhesions which cause internal organs to stick together. Dr Budden has undertaken extensive training in this type of surgery and will always aim to perform the procedure laparoscopically (key-hole). This will cause less scarring and less pain, require less time in hospital and allows better visualisation of the endometriosis and any bleeding points. Sometimes the disease is so severe that a laparotomy is required. Dr Budden will discuss the possible complications and the likelihood of them occurring if you decide to have surgery. Occasionally, Dr Budden will recommend performing the surgery alongside a bowel or bladder surgeon if there are concerns of significant disease on these organs.
Allied treatments include physiotherapy, acupuncture and counselling with a psychologist and it is recommended you discuss any of these treatments with Dr Budden. Often, endometriosis and chronic pelvic pain will lead to problems with the pelvic muscles. When the pelvic muscles become over-contracted, they may cause intermittent sharp pain at times and also lead to pain during intercourse or when using your bowels or bladder. This can be considered like a muscle cramp elsewhere in the body and treatment may be similar with physiotherapy being the first-line treatment. In certain circumstances, injections may be used to relax the muscles in the pelvis.
A clinical psychologist is a very useful person to consult if you have chronic pain. If you are referred to the psychologist, it is not because your doctor thinks “it is all in your head”, rather that traditional methods of dealing with your symptoms have been of limited help. It is very important to realise that there are two aspects to pain: