DEAR DR. DONOHUE: I have some questions about endometriosis. I have seen three doctors who think I have a case of it. One doctor put me on birth control pills, but they made me sick to my stomach. Another doc wants to check if my fallopian tubes are blocked. If so, I couldn’t have any more children. Would I have a painful pregnancy if I did? Some days I get such awful pains that I have to lie down. Is it a good idea to try for more children? I have two now, the last one six years ago. – S.W.
ANSWER: The endometrium (IN-doe-ME-treeum) is the covering layer of the uterus. Each month, during the menstrual period, the endometrium is shed. Then the uterus begins forming a new covering in the event an egg is fertilized.
Sometimes pieces of endometrium get to places they shouldn’t be. They can pass through the fallopian tubes into the pelvis, where they implant on ligaments, ovaries, tubes or even the bowel or bladder. Like the endometrium in the uterus, these transplants respond to the monthly surges of hormones. However, they cannot be shed like the uterine endometrium. They stay where they are and irritate structures they have landed on, causing pelvic pain, pain during intercourse and often infertility if they have narrowed the fallopian tubes.
The diagnosis of endometriosis can be made with 100 percent certainty when the doctor introduces a scope into the pelvis and spots the displaced tissue.
For mild pain, anti-inflammatory medicines can bring con- trol – Advil, Aleve and the like. For greater pain, birth control pills often put an end to it. Medicines that reduce the production of estrogen are also quite effective. Names of some of those medicines are Zoladex, Synarel and Lupron. Surgery is another way to treat endometriosis. Sometimes that can be accomplished with small incisions through which a scope and special instruments, like a laser, can be passed. The laser destroys the endometrial tissue.
Pregnancy just about always relieves endometrial pain.
The booklet on endometriosis delves into all aspects of this common condition. Readers can obtain a copy by writing: Dr. Donohue – No. 1105W, Box 536475, Orlando, FL32853- 6475. Enclose a check or money order (no cash) for $4.75 U.S./ $6.75 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DR. DONOHUE: How often does a person with high blood pressure have to see the doctor? I have friends with high blood pressure who see the doctor only once a year. I see mine every month. Isn’t this overkill? – F.B.
ANSWER: The frequency of visits for patients with high blood pressure depends on how high the pressure is and whether it is controlled. Very high readings that aren’t coming down require frequent visits. A change of medicines also requires frequent visits. Once pressure returns to or near to normal, then visits can be two or three times a year or maybe less often.
If you have your own blood pressure machine – they’re not expensive – perhaps your doctor won’t schedule your visits so frequently.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475.
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