DEAR DR. DONOHUE: I am 15 years old and read your article on endometriosis. On my 14th birthday I had the surgery you talked about. I would like to know a little more about this disease. Is there a chance it will return? – K.S.

DEAR DR. DONOHUE: Does endometriosis prevent pregnancy? After a hysterectomy in my 40s, I was told I could never have become pregnant because I was full of cysts due to endometriosis. – E.E.

ANSWER: Endometriosis is the condition where bits of the endometrium, the lining of the uterus, have migrated to places where they should not be – e.g., on the ovaries, or pelvic ligaments, or the bladder or large intestine. This displaced endometrium responds to the monthly rise and fall of hormones like the endometrium in the uterus does. It grows in order to foster the implantation of a fertilized egg and dries up when fertilization does not take place. Unlike endometrium in the uterus, it cannot exit the body during a menstrual period.

The transplanted endometrium causes crampy pain during the monthly period. It can also lead to heavy menstrual periods. As many as 40 percent of women with endometriosis are infertile because of it. Endometrial tissue in the pelvis can form cysts and can cause scar tissue formation, both of which disrupt normal anatomy, and that can be the reason for the inability to conceive.

This disorder can occur at any age after menstruation begins, but it more commonly happens past the teenage years.

Sometimes the only medicine needed is an anti-inflammatory, like Naprosyn, for pain control. The birth control pill can create an environment similar to pregnancy, and that can shrivel the transplanted endometrium. Medicines that stop hormone production – Lupron and Synarel, for example – are other treatment options. Endometrial tissue can also be surgically removed, often through a scope, or vaporized with a laser.

It can come back later in life.

The endometriosis story is told in detail in the booklet with that name. Readers can obtain a copy by writing: Dr. Donohue – No. 1105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My husband has Peyronie’s disease. How does it happen? Is it dangerous not to seek treatment? He is too embarrassed to see a doctor. – C.D.

ANSWER: Peyronie’s disease is not a rare disorder, and it should not be an embarrassment to see a doctor about it. Doctors encounter it many times weekly.

It’s something that comes on later in life and results from scar tissue forming within the penis. The scar tissue bends the penis and makes it difficult and often painful to have sexual relations.

The cause has yet to be found.

There is no standard, accepted treatment, and no harm comes from not seeking immediate treatment. Vitamin E, the medicine Potaba, injection of scar tissue with verapamil and surgical removal of the tissue have all been tried and have met with limited success. Your husband should at least discuss his options with the doctor.

Many times, Peyronie’s resolves, or at least causes less trouble, in a matter of a year or two.

DEAR DR. DONOHUE: My wife went to have her pro time measured, since she takes the blood thinner Coumadin. The tech took her blood pressure while she was sitting. I asked him to take it standing. He said he was commissioned to take only one blood pressure. I asked again and he peeled off his gloves, threw them into the garbage pail and ran out of the room. What would you do about this? – J.F.

ANSWER: I’d tell the doctor or whoever is the tech’s boss. Yours was not an unreasonable request, and standing blood pressure often gives valuable information about blood pressure control.

“Commissioned to take only one blood pressure” is a strange, and even laughable, reason for not honoring your request.

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, FL 32853-6475.

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