What is the best solution for endometriosis (weighing risks and long term benefits); endometrial ablation of the uterus or uterus removal? I can’t handle taking hormones. (Me and my partner don’t want children, and I am 24 years old)
Menopausal status is what usually decreases endometriosis symptoms but not in every woman. At 24, the only way to get to menopause permanently is to have the ovaries removed which would be quite drastic at age 24 and may cause you some difficulties later. The best approach would be laparoscopic excision of any endometrial implants and having a surgeon who is aware of the fact that wide excision is usually necessary since you can’t always “see” all of the endometriosis that is present.
This approach is more invasive than ablation (which may control menstrual bleeding for a time but does nothing for endometriosis) and less invasive than hysterectomy. Excision followed by a gonadotropin releasing hormone agonist was studied in a multi center randomized double blinded placebo controlled trial back in 1990 and showed that Lupron administration after excision was about 89% successful if I’m remembering the numbers correctly. So that’s a quick primer on endometriosis which is a fairly complex disease process. Hope that helps!
