December Newsletter
Endometriosis: Is There Another Treatment Option?
Endometriosis is an elusive disease, and one that often goes undiagnosed. It can cause extreme pain for some women, while many women may not even know they have it. It is estimated that over 5 million American women suffer from this disease, approximately 1/3 of which suffer significant pain. Symptoms can include severe menstrual cramps, pelvic pain, and pain during intercourse.
So what can be done to help with endometriosis symptoms?
Endometriosis affects women during their reproductive years, and it starts when uterine lining starts to grow outside of the uterus. This can vary to degrees of severity, but the amount, or locale of the outgrown tissue doesn’t directly correlate to a woman’s experience with the pain. In other words, the physical state of the disease may not dictate how much pain a woman experiences.
Endometriosis has been predominately treated surgically with a process called laparoscopy. However, there is controversy among health care providers about this approach. Some providers believe that laparoscopic surgery to remove endometrial tissue, particularly repeat laparoscopies, can do more harm than good. This is because while the pain from endometriosis may diminish, surgeries can cause scarring that can cause as much pain as endometriosis, but will no longer be limited to the time around the menstrual period. Pelvic pain due to scarring will also not be helped by hormonal treatments for endometriosis.
Contemporary therapy usually consists of either hormone blockers such as Lupron or Nafarelin which induce a menopause-like state, or a low dose, continual contraceptive that causes the endometrial lining to stop thickening, and inhibits withdrawal bleeding. Withdrawal bleeding refers to the bleeding stimulated by the lack of ingested hormones during the placebo week of traditional pill taking regimens (the “sugar pills” taken after the 21 day cycle of hormones). These are not actual “periods,” as the contraceptive pill works to prevent ovulation, and without ovulation, one does not menstruate. This state, referred to as amenorrhea, works to suppress the hormonal factors that can lead to pain with endometriosis. Hormone blockers and continous contraceptives (such as the pill, ring, patch, or depo provera) should stop bleeding from occurring and help pain associated with endometriosis.
Currently, there is no cure to this disease. Women “outgrow” it, as endometriosis no longer causes problems once a woman can no longer reproduce. However, this provides little consolation for young sufferers of this disease.
Researchers are now studying the possible use of alternative therapies in the treatment of pain related to endometriosis. Traditional Chinese Medicine (TCM) and Acupuncture will be compared to assess the efficacy of this treatment compared with hormone therapy. Various studies exist linking acupuncture and TCM to pain management (Flaws, 1989; Shattuck, 1995; Dharmananda, 1996). However, there has been little significant work in linking this potential therapy with pain associated with endometriosis. Researchers at the Oregon College of Oriental Medicine and Oregon Health and Sciences University’s Women’s Health Research Unit are currently researching this potential link.
For more information about this, and other studies conducted by the Women’s Health Research Unit, please contact us at 503 494-3666.
Heidi P. Milliken, Ph.D., Division Manager
Andrea O'Donnell, RN, FNP, Research Associate
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