Sharon’s instincts about her condition were right from the start; she would have been better off searching for a specialist in endometriosis. Specialists are a good bet because they have experience in treating endometriosis on a regular basis, frequently are involved in research on the disease, and are more skilled with the laparoscope.

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A second opinion will give you peace of mind so it is essential that you get this from a specialist well-versed in the treatment of endometriosis and one who is well up on the latest research and technology. It is important that the doctor giving the second opinion is not in the same practice as the first doctor.

When should I get a second opinion

If you are unable to communicate with your doctor or you are uneasy about your doctor’s attitude, approach and explanations then you should seek a second opinion.

You should also obtain a second opinion if you are unsure about the type of treatment recommended, or if your doctor says there is nothing wrong with you.

If you do not feel that adequate tests and evaluations have been carried out or you wish to consult a doctor who has expertise in one particular aspect of the treatment of endometriosis — such as laser therapy or infertility — then seek a second opinion.

A second opinion is important for women who:

Have been recommended a hysterectomy.

Are told by their doctor that nothing further can be done to treat their disease.

Need reassurance that the treatment suggested by their first doctor is appropriate.

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Primolut N is a progestogen (a synthetic progesterone) derived from the male hormone testosterone. Its chemical name is norethisterone. It is manufactured by Schering and sold in the form of white 5 milligram tablets.

How Primolut N works

It is thought that Primolut N eradicates endometrial implants by suppressing ovulation and interfering with the growth of the misplaced endometrial cells, causing them to slowly waste away Most women will stop ovulating and menstruating during their course of Primolut N.

Dosages of Primolut N generally used

Gynaecologists usually recommend 5 to 20 milligrams of Primolut N per day (one to four tablets per day) for four to nine months.

Side effects of Primolut N

The more common side effects are depression, weight gain, malaise, lethargy and tiredness, acne, vaginal bleeding, decreased libido and nausea.

How effective is Primolut N

There are no reliable figures on the effectiveness of Primolut N for the treatment of endometriosis.

Primolut N, pregnancy and breastfeeding

Primolut N should not be used during pregnancy as progestogens derived from testosterone can cause abnormalities in the developing foetus.

The use of Primolut N while breastfeeding is not recommended, as small amounts of progestogens have been found in the milk of mothers taking them and the effect on the child is not known.

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Most women using Duphaston only experience one or two mild side effects which sometimes settle with time.

The most common side effects that have been reported include breast tenderness, weight gain, bloating, depression, headaches, lethargy and tiredness, dizziness, nausea, irregular vaginal bleeding and cramps.

The side effects of Duphaston are reversible and they diminish soon after treatment ceases.

There are no known long-term side effects of Duphaston therapy.

How effective is Duphaston

It is extremely difficult to provide any figures regarding the effectiveness of Duphaston in the treatment of endometriosis as there has been almost no research published on the issue. Duphaston has been used as a treatment for endometriosis for many years and it has shown itself to be an effective treatment for many women. One unpublished Australian study suggests that nine months treatment with Duphaston is as effective as six months treatment with Danazol.

The only study published to-date found that 43 of the 49 women had complete or partial relief from their symptoms and of the 19 women with infertility who wished to conceive, 10 did so.

There is no information available on the recurrence rate of endometriosis following treatment with Duphaston.

Duphaston, pregnancy and breastfeeding

The manufacturers of Duphaston state that it should not be used during pregnancy as progestogens may cause abnormalities in the developing foetus.

The use of Duphaston while breastfeeding is not recommended by the manufacturers. Small amounts of progestogens have been found in the milk of mothers taking the drug and effects on the child are unknown. However, some gynecologists believe that Duphaston can be safely used during pregnancy or breastfeeding.

Interaction with other drugs, alcohol or foods

There are no known interactions of Duphaston with any foods, alcohol or other drugs.

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