Endometriosis: Hormone Therapy Versus Ablation

Endometriosis is a complex and life-disrupting condition. You may have abnormal bleeding, irregular periods, heavy bleeding, or pain. There are options for treatment, but no cure. 

Dr. Parisa Pourzand has helped many patients with endometriosis find relief from their symptoms, but choosing the most appropriate treatment depends on numerous factors. The severity of your symptoms, whether or not you want to become pregnant in the future, and several other aspects of your overall health contribute to which treatment is likely to work best for you. 

The cause of your symptoms

The lining of your uterus is the endometrium. Each month, your endometrium thickens, then breaks down, and is shed during menstruation. When you have endometriosis, your endometrium grows in places it shouldn’t be, outside your uterus. As it thickens and breaks down, there’s no way for your body to shed it. 

Endometriosis can cause quite a lot of pain, during your menstrual period, during sex, and depending on where your endometrium is growing, even during bowel movements or urination. Endometriosis can also cause infertility along with the other unpleasant symptoms. 

Hormone therapy

Hormone therapy can be an effective treatment for your symptoms. Treatments stop your ovaries from producing hormones and may stop ovulation, which is a problem if you want to get pregnant. 

Hormone therapy can slow the growth of your endometrium and it can stop scars from forming, but it won’t get rid of any existing scars or adhesions. 

Gonadotropin-releasing hormone (GnRH) medications inhibit hormones and stop ovulation, menstruation, and the growth of endometriosis. It puts your body into a menopausal state. 

However, GnRH medicines shouldn’t be taken for more than 24 months, and some forms for no more than six months. It also has some potential side effects such as headache, nausea, and sleeping problems. 

Oral contraceptives represent another potential hormone therapy to ease the symptoms of endometriosis. Usually, birth control pills make your period more regular, lighter, and shorter. There’s no time limit on how long you can take birth control pills, but if you want to get pregnant, it’s not a good choice. 

Ablation

Ablation is a procedure to remove your endometrium. It’s performed in several different ways, and it’s not appropriate if you want to get pregnant in the future because your egg implants in your endometrium during pregnancy. Since ablation is done by inserting instruments into your uterus through your vagina, it’s not a surgery. 

Some of the methods of performing ablation include using electricity, fluids, a balloon filled with heated fluid, radiofrequency, microwaves, or by freezing. Each of the methods lessens or even stops menstrual bleeding.

Ablation is best for women who are premenopausal, but who don’t wish to have future pregnancies. Your uterus should be shaped normally to be considered for ablation, as well. A congenital uterine anomaly can make it difficult or impossible for ablation to be performed safely. 

It all depends on your circumstances

There are other options for treating endometriosis in addition to hormone therapy and ablation. These are simply two of the more common treatments. 

In order for Dr. Pourzand to make a treatment recommendation, she performs an exam and takes a thorough medical history. She may also want to do some diagnostic tests before suggesting a treatment approach for you. It’s important to consider different aspects of your health, along with your goals, before choosing a treatment. 

If you’d like to learn more about endometriosis and the treatments available, book an appointment with Dr. Pourzand in her Glendale or Los Angeles office. Scheduling is easy, either online or by phone. 

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