I would like some advice about different types of treatment available and/or recommended for ovarian endometriomas.

[bertiehenry]

Having been diagnosed with these 6 years ago, after yearly checkups/ultrasounds/blood tests I would like to investigate the options open to me for removal. I feel strongly about keeping my ovaries and avoiding HRT. My next yearly appointment is next Wednesday with the hospital consultant and am concious that many consultants have a limited knowledge. Although over the last 6 years I have experienced very few painful incidences which is why I had opted for yearly checkups. However I have had 2 nasty experiences over the last couple of months. I live in Dorset. Any advice would be really appreciated.

[evanicole]

I was diagnosed in 2009 with endometriosis and ashesions. I also have a lot of other illnesses. I have had three laperascopic investigations. At my third lap in march this year I gphad my left ovary and falopean tube removed. I take amitriptoline for pain relief.

[PPSN_JudyB Pelvic Pain Support Netwo]

When you say yearly check ups , has this involved ultrasound and if so have these showed any cysts ? I only have one ovary, the first was removed in my 20's. I have kept the right ovary despite recurring cysts for 33 years, conceived with that 1 ovary and went through a natural menopause. I have had regular ultrasound scans to check it. If there is a problem with one ovary that may need surgery it doesn't mean that both have to be removed and one ovary can function for many years. It's worth finding out as much as possible from test results and also preparing what questions you want to ask the surgeon before you decide what to do.

[bertiehenry]

Thank you for your reply Judy. The yearly ultrasounds have shown that I have 2 endometriomas. One in my left ovary the size of a golf ball and one in my right ovary the size of a tennis ball. Neither of these have grown in size over the last 2 years. The last ultrasound I had last month showed the same. Originally 6 years ago both were the size of tennis balls and I have been seeing a homeopath during this time. The consultant I saw last week advised me having a laparoscopy. If they thought it possible from this, she advised that, as I want to keep my ovaries, they would attempt to remove the endometrioma from my right ovary (the largest one) and then if that was successful and my right ovary was intact, removing the other endometrioma from my left ovary. If it was not possible to remove the right one without removing my ovary, then they would not attempt to remove the left one and I would remain with it. This is something I said I would go away and think about. She gave me names of 2 local surgeons and suggested that I ask my doctor to refer me to one of them should that I wish to do so. She said it was not possible to carry out laser surgery to remove either endometrioma. What is your opinion on this advice, I would be grateful to know. Heather

[PPSN_JudyB Pelvic Pain Support Netwo]

Endometriomas are best dealt with by excision rather than laser. They can also biopsy the tissue when it is excised. ( you may have to ask them to do this though )

How old are you and do you intend to try and conceive at some point ? it makes sense to preserve whatever possible

[bertiehenry in reply to PPSN_JudyB]

I am 47. I am assuming that HRT is the only option if both ovaries are removed, do you agree? What would be the advantage of having a biopsy, in case they are cancerous?

[PPSN_JudyB Pelvic Pain Support Netwo in reply to bertiehenry]

Removal of both ovaries before the menopause has a pretty drastic effect. If the cause of the cysts is endometriosis HRT may not be recommended. I would want to know what kind of cysts they are in order to make a long term decision about treatment.

[xweeta]

Ovarian endometriomas can reduce in size just by taking continues birth control pills (stop the periods). Of course that you have to find one pill that works for you. the ones with 0,03 of estradiol are better for stop menstruation.

In my case in 6 months, one supposedly has disappeared the other one has reduced in size (i had two in the two ovaries). they had between 3 and 4 cm.

however, in my case, my pain is not gone. Probably it comes of another site.

From what I read, in surgery trey have to remove the endometrioma and the capsule. If they just draining it tends to reappear.