Dual therapy improves endometriosis pain control
NEW YORK (Reuters Health) - Hormone suppression and diet therapy can relieve pain in women with endometriosis who undergo conservative therapy, according to a report in the medical journal Fertility and Sterility.
Although most women experience pain relief after undergoing minimally invasive surgery to remove excess endometrial tissue, the authors explain, about one quarter report worsening of pain and more than one third eventually require further surgery.
Endometriosis is a painful condition, affecting women during their reproductive years, caused by the growth of endometrium -- the tissue lining the uterus - in other parts of the abdomen outside of the uterus.
Dr. Francesco Sesti and associates from Tor Vergata University Hospital, Rome, examined the effectiveness of 6 months of hormone suppression therapy or diet therapy to relieve pain in 222 women who had conservative pelvic surgery for severe endometriosis.
One hundred ten women received placebo (sugar pill), 35 were assigned to dietary supplementation with vitamins, mineral salts, lactic ferments, and omega-3 and omega-6 fatty acids, and 77 women were treated with hormone suppression therapy.
Women in both the hormone suppression and dietary therapy groups reported less menstrual pain, nonmenstrual pelvic pain, and pain during intercourse at 12 months' follow-up than did women who received placebo, the authors report. Women in all treatment groups also experienced significant improvements in quality of life measures.
The study findings support the use of hormone suppression or dietary therapy for women who still experience pain after conservative pelvic surgery for endometriosis.
Additional clinical trials in which a larger group of women are randomly assigned to treatment with long-term follow-up are needed to confirm these results, and to identify the most effective postoperative treatment for women with severe endometriosis, the investigators add.
SOURCE: Fertility and Sterility, December 2007.
