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	Back to Library Home Endometriosis Frequently Asked Questions About Endometriosis Q 1: What are the disadvantages of excision of endometriosis? A: Excision creates more scarring. This is my own experience and that of other gynecologists I have communicated with. The use of the laser to evaporate the endo must be done making sure that the tissue is destroyed deeply enough however. Q 2: Do you (Dr. Howard) use natural hormone therapy and what is the name of the hormone? A: I always use estradiol. That is the hormone women make for themselves. For more information, refer to our library article on estrogen pellet therapy. Q 3: How do you decide on the level of hormones required? A: Since I use estradiol, the woman’s natural hormone, we can test your blood and determine the level of estradiol without guess work. As long as your level is high enough to protect your body from bone disease and other health issues, then you decide at what level you are feeling your best. Q 4: When you use laser, how do you do a biopsy of the tissue, since it is vaporized? A: I have had the opportunity to see endometriosis for over 25 years, so it is usually not necessary for me to biopsy to make a diagnosis. However, if a biopsy is called for, it is easily done using laparoscopic scissors. Q 5: What kind of laser do you use? A: I use the KTP laser. Q: 6 I am afraid of the side effects of hysterectomy. Is there a reliable resource you could point me to or could you provide feedback. This is a tough decision. A: All of my patients who have had a hysterectomy think it is one of the best things that has happened to them. They have increased energy, sex drive, feeling of well being, and report their families are also happy. However, you no doubt have heard worrisome things from various sources that hysterectomy can cause loss of sex drive and/or sexual response loss of sexual sensation due to the removal of the cervix, or increase in bladder control problems, or loss of abdominal muscle tone. Let me address these in order: Loss of sex drive/response can occur is the appropriate hormone replacement therapy is not given A carefully conducted study has finally put to rest the notion that removing the cervix causes loss of sexual sensation. The study was published in 2005 which showed no difference in “sexual functioning and quality of life” whether the cervix is removed or not during hysterectomy. There is not clear indication that hysterectomy adds to the risk for bladder control problems. Loss of abdominal muscle tone is not a problem whether the hysterectomy is performed laparoscopically or through a larger incision. Loss of abdominal muscle tone is due to lack of exercise.