quote:
Originally posted by ArtnSoul:
The doctor currently has her on a Lo-Ovral been on low dose birth control for about 2 1/2 years because of heavy irregular periods and painful cramping.After she heals from the surgery, he wants to put her on a medication that would keep her from getting her period for about 6 months - to "Push back" the endometriosis.
To make it as inactive as possible, then she would have to stay on birth control until she is married and decides to have children.
He is very conservative, and saaid that if she were in her 40's and had all the children she wanted, he would do a hysterectomy. But since she is only 18 he will not do anything that would rob her from being able to have children.
Hi ArtnSoul,
So sorry to hear that your daughter is dealing with so many painful health problems.
I have been dealing with endometriosis since my first period, I am sure, but it took 20 years before it was diagnosed. I have done a lot of research on endo and am in contact with a lot women that also have endo and associated problems. I have a website with a forum for Endometriosis, if your daughter (or yourself) is interested. You may email me for info, if you like.
Just as everyone here knows how important it is to seek out a LLMD, it is no less important when dealing with endometriosis - can't stress that enough!! Retaining fertility is a very big reason, as you have mentioned.
Was your daughter's surgery only diagnostic in nature? No endo removed?
You and she need to read up on the drug her doctor is advising she go on after surgery. I am sure it is one of the GnRH drugs, usually Lupron, in the US. This drug should never be taken without knowing the risks involved - weighing the benefits against the risks. The list is VERY heavily weighted to the risk/little benefit side.
One of the most important things to know about the GnRH drugs is that due to permanent side effects that can occur (bone loss) it is not recommended for more than 6 months use in a LIFETIME. SO, even if this drug might help someone during that time (which it often does not and can even increase pain and discomfort from side effects), any POSITIVE effects do not last - THEN WHAT - other treatment is still needed.
One is trading a 'possible' few months of some relief for possible long term permanent side effects, such as bone loss. Memory loss may occur, along with a multitude of short term and/or long term side effects.
The EXPERT endo physicians consider aggressive conservative surgical excision of the disease the most effective means of eradicating the endo lesions, thus bringing the most symptom relief and the best chance at preserving fertility.
This type of surgery requires a very skilled eye and trained surgeon in removing endo. Endo lesions can present in many different colors and appearances, it can be very hard to see and recognize, it can be embedded in adhesions, along with the cysts and lesions and adhesions that can easily be seen. It takes a very skilled and trained endo surgeon to provide the best results.
You mentioned that your daughter is on oral contraceptives. This can afford some good pain control and possibly help to slow down the endo, but it does not work for all women. Different pills may need to be tried and different ways of taking it. A monophasic pill is recommended for endo (one that delivers the same hormone dose in every pill, unlike the tri-phasics with different hormone amounts in different pills taken at different times during the cycle, etc).
For many women with endo, the Pill is most effective when taken on continuous dosing. This means that your daughter would not take a 7 day pill break every 3 weeks, but would take active pills only (no sugar/inactive pills) for at least 3-4 months or more at a time to suppress her having a period for longer stretches of time. This can be very beneficial and MUCH safer (if she has no contraindications to taking the pill) and much better tolerated than the GnRH drugs with 6 month limited use.
Personally, my choice was to take CBCP (continous birth control pills), which is what worked quite well for me, inspite of the extensive amount of endo I have had. 3 weeks on, 1 week off did not help me. I would have opted for surgery again WITH an endo expert surgeon this time around, but with my other health problems, did not feel I was a good surgery candidate. It also meant traveling a long distance for the surgery and with my fatigue and muscle problems (fibromyalgia and myofascial pain syndrome), bad lower back, etc, which I was unable to do. I went the route of CBCP. I am now in menopause and my endo situation is doing better.
I had several large cysts (endometriomas) on my remaining ovary discovered 6 years ago. They should have come out - but for the reasons stated above, I was on CBCP for the past 6 years (very few breaks to bleed) and monitoring of the cysts. My gyn did not think I could hold out - but I have made it - it wasn't always easy, that's for sure. He was the first to High Five me when my ultrasound a year ago showed the cysts reducing in size!! His comment, "patience paid off!" HOWEVER, this is not a recommendation for that approach to dealing with endo, it was what I felt I had to do in my specific situation. It has been a gamble, but much is with endo. I am not out of the woods yet, dealing with some new issues and now since stopping the pill in March and entering menopause - we are entering a new phase to see how I will do. Unfortunately, at the ultrasound I had done this month, I have added another cyst back, but the 2 I have are both small, thankfully. I hope they stay that way and better yet, disappear.
One other thing I wanted to add about Lupron and the bone loss issue. When Lupron is used on young women, one also needs to consider that, depending on their age, they may still be putting on bone growth, so how detrimental might this be to take Lupron at that time?!
Lupron throws a woman into a menopausal state and the side effects can be very difficul - and for what - it is only a bandaid for a short period of time, one which may leave her with more problems on top of the ones she already has. Once the Lupron is stopped, the disease is quickly worsening, because it was not removed, only 'shrunk down' some (again, providing it even helped).
I also want to state that I am giving you my opinion on it here as my personal opinion on the drug, so that you will do your own research into it and you and your daughter make your own choice as to what YOU both feel is best. On my endo forum, our purpose is to share our experiences and NOT JUDGE what treatment choices each woman makes. Every woman is different in what may help her and what she feels is the best for her or what she feels she must try. We are there for support in her treatment choices and in any way needed.
I would like to give you a link to a site that I feel has excellent information on the disease and treatment. Dr. A at this site would be my choice for a surgeon, but there are others around the country. He is my personal choice from all I have heard about him from his patients.
I might be able to help you with a doctor recommendation in your area (don't know where you are from).
Almost forgot, as far as pelvic congestion - yes I know what that is. I know of others with endo that have it as well.
Well, this has gotten very long, but I hope it can be helpful. Again, my best to you and your daughter. My heart goes out to both of you.
Sue
Here is the link to the site with accurate endo info: http://www.centerforendo.com/
You will probably want to start with Basic Q&A Especially note what Dr. A has to say about GnRH drugs, like Lupron.
Edited this to add that I now see you are from PA. There is Dr. R that you might consider, IF you would like to find a doc with expertise in endo. Here is link to his site: http://www.adlap.com/reich.asp
Here is a page on that site about surgery: http://www.adlap.com/endoExcision.htm
You can explore the site, lots of info there too. I have not read through it lately, so can't comment on my thoughts about it at this time, but wanted to give you the link so that you can read it if interested.
[This message has been edited by BambiLand (edited 27 October 2004).]