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Suggest Treatment For Recurring Endometriosis

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Posted on Fri, 13 Mar 2015
Question: Hello Dr. XXXXXXX
I am 38.5 years old,5.3" height and I weigh 67 kgs.
I am a known case of Endometriosis Grade III and was operated upon 3.5 years back(june 2011).Laproscopy was done to remove the endometriotic cysts from the ovaries and adhesions were removed.After that,to control the situation,I was given an option of OC pills,Zoladex and Mirena.We chose the pills and I have had Novelon ever since-42 tabs back to back,a break of 7 days and continue.I responed to this treatment well and there was no recurrence of cysts.In september,2014,my doctor asked me to discontinue the pills as I was on them for 3-4 years.After 3 months,I got a scan done and I was not surprised that the cysts and adhesions came up again.Now,my doctor says it is not a good idea to continue with combined pill.I should get Mirena inserted or take Endosis tabs 2 mg.Hysterectomy is not advisable considering my age.I have 2 children-10 years and 7 years and tubal ligation was done at the time of lap.Please advise.
doctor
Answered by Dr. Nandita Thakkar (29 minutes later)
Brief Answer:
further management of the endometriosis

Detailed Answer:
Hello

Welcome to HCM and thank you for writing in to us

Endometriosis is a condition which keeps coming back and there is no proven effective drug to prevent the recurrence.

Even after a perfect removal and clearance at a surgical intervention by the consultant they can reform

If your symptoms of pain is severe then we need to intervene
The use of progesterone Intrauterine device ( MIrena) will control the spread of the condition to some extent

The other drug now recommended in practise is the use of Norethisterone 5mgs on daily basis to prevent the spread

you can meet your consultant and discuss the options for further treatment

Wish you all the best

Dr Nandita Thakkar

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Nandita Thakkar (15 hours later)
Dear Dr XXXXXXX
The decision that I need to take now is between Mirena or the mini-pill viz.endosis 2 mg.Will I be able to take this pill for a long time considering that I am almost 39 or will it be a good idea to have it for a while and check its efficacy and then go for Mirena.
I have had 2 LSCS and my uterus is ante-verted and pulled up.
Hence my worry is will Mirena stay in place or there are chances of expulsion/PID etc.My libido has also gone down after I started on the pills some 3 years back and I have complains of low back ache and migraine.
In light of all these,please advise the best plan doctor as I am really counting on this.
doctor
Answered by Dr. Nandita Thakkar (31 minutes later)
Brief Answer:
mirena will be the option for you

Detailed Answer:
Hello again

Looking at your case, the options will be mirena in view of your age and side effects you have mentioned in your history by using the pill.

The chance of PID and expulsion of mirena are low.

Hope to have answered your query.

Dr Nandita
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
Dr.
Dr. Nandita Thakkar

Infertility Specialist

Practicing since :1992

Answered : 218 Questions

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Suggest Treatment For Recurring Endometriosis

Brief Answer: further management of the endometriosis Detailed Answer: Hello Welcome to HCM and thank you for writing in to us Endometriosis is a condition which keeps coming back and there is no proven effective drug to prevent the recurrence. Even after a perfect removal and clearance at a surgical intervention by the consultant they can reform If your symptoms of pain is severe then we need to intervene The use of progesterone Intrauterine device ( MIrena) will control the spread of the condition to some extent The other drug now recommended in practise is the use of Norethisterone 5mgs on daily basis to prevent the spread you can meet your consultant and discuss the options for further treatment Wish you all the best Dr Nandita Thakkar