According to the American College of Obstetricians and Gynecologists the “standard” for treatment of painful periods is STILL to treat for 3-6 months with hormones (without a diagnosis to what is causing the pain). These hormone treatments can be anything from birth control to Lupron. None of these treatments cure the disease or even have been proved to preventing progression. During this time adhesions, central nervous system up regulation of pain, and damage to internal organs can take place. If hormones don’t mask the issue well enough “conservative surgical therapy” is recommended. IE ablations of endometriosis on low risk structures. Conservative ablation has been shown to increase scar tissue, increase the spread of endometriosis due to increased growth factors near and around lesions that were not completely removed, and most importantly ablation has been shown to be ineffective for treatment of pain.
MOST women have pain come back as soon as 2 months after ablation surgery. Because of this, ACOG recommends more hormone therapies and repeat ablations until the person reaches an age when hysterectomy is possible. The craziest part… they suggest removal of the uterus and ovaries to cure the disease once these methods fail. Why are we removing the uterus for a disease, that by definition, is not in the uterus?!
According to the best endometriosis specialists in the world the standard of care should be quick diagnosis and complete surgical treatment of endometriosis even when it means drastic and complex surgery. This can help prevent repeat surgeries, is the only treatment shown to have a long term success rates higher then 30%, it can prevent loss of fertility, adhesions from failed treatments, side effects of hormone treatments, and more. Some great doctors still believe in excisions paired with ablation and other believe in ablation alone. Either way a complete surgery to address all lesions must be performed. Patients should educate themselves on the benefits and risks of ablation and excision and excision only and make the choice for themselves. So why is ACOG still advising dangerous hormone therapy at young ages without a diagnosis, repeat incomplete ablations, and hysterectomy when they all have been proven to cause (in most cases) more harm then good?! Let us listen to the best in the industry like Dr. Malcom Makenzi. Let us push to have students and gynecologists be educated on what the true standard of care for endometriosis should be! We won’t be silent!