Natural solutions
Several plants can help with hormonal regulation. Endometriosis is an estrogen-dependent condition, meaning that it is stimulated by estrogen, one of our female sex hormones. Therefore, estrogen-lowering therapies may help slow the progression of lesions and relieve symptoms and signs. On the same principle, phyto-hormonal treatment consists in continuously giving plants with strong anti-estrogen activity.
The Center Afrique Santé Bio (ASB) provides you with a natural cure treatment for endometriosis. It's a very effective treatment. The patient survives for 3 months. After these three months, the patient can go and do a test again so that the center can know what treatment to give.
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This herbal treatment must be completed with a comprehensive management. The problem must be addressed as a whole: alleviating pain, reducing the frequency and amount of bleeding, slowing ovulation, and relieving psychism. For example, I always prescribe magnesium and vitamin B6.
I advise to use therapies that act on the neuro-psychic component (anxiety, depression), venous and lymphatic circulation, pelvic congestion or digestive disorders. My suggestions: general and gynecological osteopathy, the Mézières method, lymphatic drainage, acupuncture and traditional Chinese medicine.
Alternative Medicine
If the combination of these natural treatments can relieve patients, chemical and/or surgical treatments may sometimes be needed. I am thinking, for example, of infertility situations, where accepting heavy treatments for endometriosis may prevent the use of (even more burdensome) assisted reproductive techniques.
Consultation with a specialist remains essential.
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EVALUATION FOR ENDOMETRIOSIS
Because endometriosis is often diagnosed late, it may take several years from the first symptoms until the diagnosis is confirmed.
The attending physician evaluates the nature and extent of the pain symptoms. If needed, they refer the woman to a gynecologist or gynecologist-obstetrician, who examines her for suggestive findings. Occasionally, these findings are completely normal, but the diagnosis of endometriosis is not ruled out.
To help refine the diagnosis, doctors may do certain tests.
Ultrasonography of the abdomen and pelvis
Ultrasonography of the abdomen and pelvis can show endometriosis.
To better detect some endometriosis injuries, pelvic ultrasonography is done transvaginally (the ultrasound probe is placed in the vagina, so high-quality images can be obtained).
Endometriosis: When is MRI useful?
MRI is prescribed for the following:
- check the peritoneum or viscera (rectum, vagina, uterus, bladder, ureter, small intestine, etc.) for endometriosis;
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- define their number and location before possible surgical treatment.
Other tests depending on the location of endometriosis
If colon involvement is suspected, a colonoscanner may be done to accurately record digestive tract injuries. Coloscanner is done by doing an abdominal-pelvic CT scan after the colon is filled with water by placing a cannula in the rectum. This well-supported examination requires no special preparation.
Endoscopic ultrasonography of the rectum, done by a gastroenterologist, may be needed if there is damage to the digestive tract. It allows the digestive tract of the rectum and sigmoid to be seen very precisely up to 40 cm from the anus.
If necessary, if urinary endometriosis is suspected, specialized advice is sought and a urinary tract evaluation (renal ultrasonography, MRI urography, etc.) is also planned
The Place of Laparoscopy in Endometriosis
Laparoscopy is considered only in certain cases. It is used to explore the pelvic and abdominal cavity and identifies the following:
- endometriosis lesions (number, location);
- possible fibrous and scar adhesions.
This test also allows endometrial tissue to be removed from the lesions, analyzed, and confirmed (called a pathologic examination). At the same time, it usually removes visible damage (therapeutic phase).
Laparoscopy limits the opening of the abdominal wall. This technique begins with making four small incisions to inject gas into the abdominal cavity. Then, the surgeon inserts surgical instruments and a miniature camera through the openings into this space. This allows her to operate by monitoring her gestures on a video screen.
After the evaluation, a review of organs affected by endometriosis
The balance sheet shall be used to define:
- adenomyosis: the location of endometriosis in the muscle of the uterus,
- superficial endometriosis localized only to the peritoneum,
- ovarian endometriosis,
- deep endometriosis with or without digestive tract involvement.
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HOW ENDOMETRIOSIS PROGRESSES
Endometriosis is a chronic disorder that develops throughout a woman's period of genital activity. Thus, with each menstrual cycle, the sores proliferate, bleed, and leave fibrous scars.
With treatment, symptoms lessen and the damage resolves. In all cases, endometriosis decreases (and usually disappears) after menopause.
However, complications remain possible, including:
- adhesions;
- rarely, pneumothorax, which occurs during menses if lesions are present in the pleura;
- infertility (very common). Usually, it occurs in severe endometriosis.
when lesions reach the peritoneum, ovaries, or fallopian tubes. In fact, it is common for the evaluation related to infertility to reveal endometriosis.
When to start endometriosis treatment?
Starting treatment is recommended only when endometriosis affects daily life or organ function.
To reduce endometriosis injuries that are hormone-dependent and that progress with the menstrual cycle, doctors prescribe drugs that cause menstrual periods to stop (amenorrhea). With no menstrual periods and thus no bleeding from endometriosis lesions, pain lessens or disappears and the lesions regress.
However, some injuries, such as adhesions, endometriomas (located in the ovary), and scarring that is fibrous, are insensitive to hormones and do not regress with this treatment.
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Choice of drugs to treat endometriosis
When determined in consultation with the young woman, it takes into account the contraindications of the drugs, their possible adverse effects, and the person's health status.
First-line hormone therapy
Combined hormonal contraceptives: Some combination hormonal contraceptives used continuously suppress menstrual periods.
Levonorgestrel-releasing intrauterine system (IUD) insertion.
Second-line hormone therapy
Oral microprogestogen contraception with desogestrel.
Etonogestrel implant. It is a long-acting subcutaneous implant that releases a progestin and provides effective contraception.
Chlormadinone acetate (Luteran). The High Authority for Health states that, in the absence of recent data, the place of chlormadinone acetate (Luteran) in the treatment of endometriosis cannot be specified. Tell your doctor if you are taking or have been taking this medicine.
Progestogens Lutenyl and Luteran: warning from the National Agency for the Safety of Medicinal Products
There is an increased risk of meningioma (tumor, most often benign, of meninges, brain and spinal cord envelopes) associated with the use of nomegestrol acetate (Lutenyl and generics) and chlormadinone acetate (Luteran and generics).
Tell your doctor if you are taking any of these medicines.
Gonadotropin-releasing hormone (GnRH) analogs. These drugs prevent the production of gonadotropic hormones, which stimulate the ovaries and thus lower the level of estrogen (hypoestrogenism). This results in the suppression of menstrual periods (amenorrhea) and simultaneously the disappearance of bleeding from endometriosis lesions.
These drugs are prescribed for 3 to 6 months, up to a year. They have side effects—hot flushes, dry skin, bone demineralization, or osteoporosis—related to the hypo-estrogenesis they cause. These are corrected with add-back therapy: a small amount of estrogen is reintroduced into the body, under medical supervision, prescribed before the 3rd month of treatment.
Dienogest (a hormone that acts like progesterone).
Relieving endometriosis pain
Pain management is individualized for each patient and combines hormonal treatments, possibly surgery, and analgesics.
Pain is related to the inflammatory process, irritation of nerve endings, and immobility of tissues in response to pain.
To relieve pain due to endometriosis, doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs). Nonsteroidal anti-inflammatory drugs should not be used when contraindicated or for long-term use because of their gastric and renal side effects. If necessary, treatment should follow the following rules and be taken on medical advice:
Use the NSAID at the lowest effective dose.
Do not exceed 5 days of pain treatment.
Discontinue treatment as soon as symptoms resolve.
Other drugs that relieve endometriosis pain include antidepressants used to relieve pain.
Nondrug therapies are often useful to improve quality of life and combat pain, supplementing medical care:
- acupuncture,
- osteopathy (non-manipulative manual therapy, such as fasciotherapy),
- yoga,
- hypnosis.
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