Here’s a story about very heavy periods. It’s 7pm on a Friday night when I get a panicked call from my patient Karen. She’s bleeding so heavily that she cannot leave the bathroom. She’d been at work earlier when she soaked through three super tampons in an hour and then ruined her favorite pair of jeans. Her work colleague had to help her into a taxi. Karen is understandably frightened. I send her to a local medical center for the clotting drug tranexamic acid, which will slow her bleeding.
I know what will happen next. Karen will meet with her gynecologist who will tell her that her only options are the pill, the hormonal IUD, or surgery. Karen had always tried to use natural treatments. She never imagined she would end up in a situation like this.
A change is coming for endometriosis treatment. Until now, the clinical approach has been surgery followed by hormonal suppression with the hormonal birth control or other drugs. Going forward, the approach will shift to anti-inflammatory and immune-modulating treatments. That’s because there is growing evidence that endometriosis is not primarily a hormonal condition. It is autoimmune.