When to treat?
Endometriosis is a benign condition. Typically, the choice of treatment is guided by the patients’s symptoms, wishes and preferences. However, factors that may also play a role include:
Depending on all of these factors, along with the patient’s preferences, treatment options will be discussed. It will be a shared-decision what treatment would be most appropriate taking the symptoms, wishes and medicall situation into account.
Roughly, there are three categories of treatments to choose from, and often a combination of treatments is needed. A patients preference and choice of treatment may change over time.
The goal is to improve the quality of life and, in cases of organ threat, to protect the patients health.
Symptom control in Endometriosis, complementary treatments
In symptom control, the main focus is on relieving symptoms. The endometriosis itself might not directly be treated. The aim is to find the best way to control the symptoms and to make the symptoms more bearable.
Pain Relief
There are various forms of pain relief or pain management. In endometriosis, this usually consists of a combination of Paracetamol and Naproxen or the combionation of Paracetamol and Ibuprofen. Naproxen and Ibuprofen are NSAIDs, non-steroid anti-inflammatory drugs, and therefore effective for pain caused by endometriosis.
There are many more types of painkillers, and depending on the type of pain (post-surgical pain, nerve pain, or chronic pain), the most suitable pain medication for you will be considered. Sometimes a consultation with a pain specialist may also be necessary.
Dietary Advice
Many patients with endometriosis experience digestive issues. Bloating, changes in the consistency of bowel movements, and nausea are common complaints. Many of these symptoms resemble irritable bowel syndrome (IBS). For this, the FODMAP-restricted diet has been developed.
Diet can help in reducing these symptoms. In addition to a specific diet, a well-balanced and varied diet is also important.
At the Dutch Endometriosis Center, we offer you specialized guidance from a dietitian. This is done in collaboration with FOCUS Dietetic Practice. This practice, in addition to other specialties, focuses on supporting women with endometriosis.
Psychological Support
The impact of a chronic illness is significant. For many women, the often long-term trajectory and the limitations caused by their symptoms and/or treatments are burdensome. Women with endometriosis are more likely to experience anxiety and depression symptoms when compared to women without endometriosis.
At the Dutch Endometriosis Center, we offer psychological support in short-term treatment programs. This is provided by Cobie Lutters, a medical psychologist with over 10 years of experience in the field of endometriosis.
Pelvic Physiotherapy
Chronic (abdominal) pain symptoms can cause a tense/hyperactive pelvic floor. This can result in issues with urination, bowel movements, or pain during intercourse. A pelvic physiotherapist specializes in treating this overactive pelvic floor and can help reduce the symptoms.
At the Dutch Endometriosis Center, we offer guidance from a pelvic physiotherapist. The pelvic physiotherapist we collaborate with most often is Catherine van der Grijp, but a pelvic physiotherapist in your local area may be more practical.
Complementary Medicine
Complementary medicine largely falls under non-mainstream healthcare. Often, it is care that has not been scientifically proven to be effective for women with endometriosis. However, women report support from this type of care in improving their quality of life. For example, it has been proven that yoga or meditation can help alleviate symptoms for people with chronic illnesses.
You can always ask your healthcare provider if the complementary care you wish to start is compatible with other (medical) treatments.
You can always ask your healthcare provider if the complementary care you wish to start is compatible with other (medical) treatments.
Hormonal Therapy
Endometriosis is an estrogen-dependent condition. Estrogen is a natural hormone needed for the menstrual cycle. Suppressing estrogen can help reduce symptoms. This is done through hormone treatment. With hormone treatment, we alter the hormone balance in the body. The goal is to lower the production of estrogen in the body or, in some cases, even stop it (almost) completely.
Types of Hormonal Treatments
These treatments have different effects on lowering estrogen. As a result, the side effects also vary per method. Every woman responds differently to medication, so it is difficult to predict in advance which treatment will be most suitable for an individual.
Lowering estrogen doesn’t always help or may not be enough to alleviate endometriosis symptoms for everyone. There are several causes for pain in women with endometriosis. If not all causes are addressed, there may be persistent symptoms.
Surgical Treatment
Surgery may be performed if medically necessary, if other treatments have not been sufficient, or in preparation for fertility treatment. Sometimes surgery is performed to proof the diagnosis, but based on the latest European guidelines, this is no longer essential.
Surgery in the abdominal cavity is almost always done via laparoscopy (minimally invasive surgery). Small incisions are made in the abdominal skin, through which tubes are inserted, allowing a camera and instruments to be used.
The type of surgery, preparation, recovery, and risks differ for each woman. Therefore, we create a personalized surgical plan in a multidisciplinary team setting.
