Currently, there is no cure for endometriosis. Treatment focuses on reducing pain and preventing infertility. Possible treatments range from oral medications to birth control pills to surgical solutions, such as laparoscopy. There are also alternative treatments for endometriosis.
To help determine the best treatment for you, your doctor will consider factors such as:
- pain level
- desire to get pregnant
- overall health
Endometriosis is a chronic (long-term) disorder that can affect anyone with female reproductive organs. This occurs when endometrial tissue (tissue that lines the uterus) grows outside the uterus, where it does not. Pain, ranging from mild to debilitating, is the most common symptom.
When you have endometriosis, the endometrial tissue growing outside your uterus is affected by the same hormonal changes that come with menstruation. It thickens throughout your cycle and then breaks down and bleeds. This can cause swelling.
Over time, this can lead to a buildup of scar tissue and adhesions that can interfere with fertility.
Medications, both prescription and over-the-counter (OTC) drugs, can reduce inflammation and provide pain relief. If your pain level is low, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil/Motrin) and naproxen (Aleve) may be needed to control your pain.
But many people need additional medications or treatments to help improve their quality of life. Medications used to treat endometriosis include:
birth control pills
Medicines such as birth control that help regulate hormones are among the most common treatments for endometriosis. They help reduce the pain and cramps that occur around your period. They can also prevent the formation of new adhesions and scar tissue.
Hormonal contraceptives work because they help regulate and stabilize estrogen and progesterone levels. When your hormones don’t increase, endometrial tissue growsDoes not thicken and causes swelling.
Many birth control pills are taken only 21 days a month, followed by 7 days of placebo (sugar) pills. For endometriosis, doctors often recommend a continuous-cycle option without placebo pills. Eliminating placebo days keeps hormone levels even more stable.
Birth control pills usually shorten and lighten your periods. Continuous-cycle pills can also be used to reduce the number of periods you have or stop them altogether.
For those who are planning to become pregnant in the near future, birth control pills are a good option, as they can be easily stopped.
IUDs and other hormonal contraceptives
Hormonal birth control only reduces symptoms of endometriosis while you are using it. If you stop using it (or forget to take your pill regularly), your symptoms are likely to return.
For a more reliable, long-term solution, you may want to consider other hormonal contraceptives. IUDs that contain a progestin, such as Mirena, are a great option.
Hormonal IUDs work similarly to birth control pills to prevent thickening of endometrial tissue. They can reduce cramps and make your period much lighter. Some people stop their periods completely.
Hormonal IUDs last for many years and can be removed if you decide to become pregnant.
Other hormonal contraceptive options include:
GnRH (gonadotropin-releasing hormone) agonists
GnRH agonists stop your ovaries from making estrogen. It inhibits ovulation, menstruation and the hormonal cycle that aggravates endometriosis.
GnRH agonists are available as a nasal spray or injection. They are also available in pill form.
These drugs can cause a number of unpleasant side effects during menopause, including:
They can also lead to bone loss and other complications if taken for a long time.
Danazol is a synthetic steroid that mimics testosterone, a male reproductive hormone. Taken in pill form, this medicine prevents ovulation from occurring. You may have few or no periods while you are on this medicine.
Danazol can cause “masculinization” side effects, such as deepening of your voice. It can also harm the developing fetus. You should not take this medicine if you are or may become pregnant.
Endometriosis surgery may be done to both confirm the diagnosis and treat the disease.
The benefits of surgery can be temporary or permanent. Before consenting to any procedure, talk to your doctor about whether you want to conceive in the future. Certain procedures increase the chances of pregnancy. Others will nullify your ability to conceive and carry a child.
Laparoscopy is a minimally invasive surgical procedure that allows your doctor to see the inside of your abdomen with a tiny camera. This is the gold standard for diagnosing endometriosis. It can also be used to treat disease.
During diagnostic laparoscopy, a small incision is made in your abdomen, and a thin tube with a camera on its end is inserted. This allows your doctor to see how advanced your endometriosis is.
If your surgeon chooses to proceed with treatment, they will remove the excess tissue through another small incision. They can also destroy scar tissue and adhesions.
Removing this tissue may make it easier for you to conceive. It can also reduce your pain level.
Laparoscopy may be a good option for you if your symptoms do not improve with medication alone. It is not a cure for endometriosis. Endometrial tissue often grows back over time.
Other Surgical Options
Other surgical treatments for endometriosis are much more invasive. For this reason, they areNot as common as they used to be. examples include:
- Laparotomy. This major surgical procedure is sometimes performed to remove endometrial and scar tissue. Because it involves large incisions and an extensive recovery, it is not common.
- Hysterectomy. This is the surgical removal of the uterus. While it may reduce pain in people who do not plan to have children, it can have adverse health consequences in young people.
- Oophorectomy. This is the surgical removal of the ovaries. It may help improve symptoms, but it brings on early menopause. Early menopause carries its own health risks.
Some people with endometriosis have difficulty getting pregnant. Patches of endometrial tissue can:
- block fallopian tubes
- damage to the ovaries
- change pelvic environment
For many people, laparoscopy with tissue removal is enough to restore fertility. If you do not become pregnant after surgery, your doctor may recommend additional fertility treatments.
Fertility Drugs and IUI
Fertility drugs, such as clomiphene and gonadotropins, are sometimes used to stimulate ovulation. They stimulate ovulation and help prepare the body for pregnancy. Clomiphene is taken in pill form for about 5 days during each cycle, while gonadotropins are taken by injection.
In people with more advanced endometriosis, fertility drugs are often combined with intrauterine insemination (IUI).
IUI is a type of artificial insemination that is done in a doctor’s office. Using a sperm sample from a partner or donor, your doctor will insert the sperm directly into your uterus.
In Vitro Fertilization (IVF)
IVF is a form of assisted reproductive technology designed to help you become pregnant. The process involves several steps, including:
- Taking hormonal drugs that help you produce many eggs.
- Removing your eggs through a short outpatient procedure called egg retrieval.
- Placing embryos directly into your uterus with a pipette during a process called embryo transfer.
Since menstruation stops during pregnancy, many people experience relief from pain and other symptoms of endometriosis during this time. After delivery, your symptoms may return.
You may be able to ease the pain of endometriosis through alternative treatments. Ask your doctor about any natural remedies you’re considering. In some cases, they may be compatible with medical treatments you are already having. In other cases, they may conflict.
Natural treatments for endometriosis may include:
- Acupuncture. a
study reviewindicates that acupuncture can reduce pain caused by endometriosis. Although more research is needed, studiesIt is also indicated that acupuncture improves IVF outcomes.
- Anti-inflammatory diet. Since endometriosis causes inflammation, avoiding foods such as red meat and following an anti-inflammatory diet may be beneficial.
- Massage. A type of massage therapy called osteopathic manipulative therapy can help relax the pelvic muscles and reduce pain. It may also be beneficial for reducing inflammation.
endometriosis treatment at home
Home remedies can ease your problem. examples include:
- NSAID. Non-steroidal anti-inflammatory drugs such as ibuprofen (Advil/Motrin) can reduce pain and swelling.
- Exercise. Exercising regularly has many benefits, including reducing stress, supporting pain management, and reducing inflammation.
- Heat. Try placing a hot water bottle or heating pad on your stomach.
- Attention. Meditation helps reduce stress and improve pain management.
- Tea. Drinking tea with anti-inflammatory properties such as ginger and turmeric may help.
You don’t have to live with endometriosis pain. Have an open conversation with a doctor you trust about your quality of life and what you are going through. When people feel too embarrassed or awkward to discuss certain symptoms with their doctors, they don’t get the treatment they need.
Keep in mind, historically, doctors haven’t done a very good job of handling women’s pain. If your doctor isn’t taking your symptoms or concerns seriously, find a sympathetic gynecologist who will. The American College of Obstetricians and Gynecologists has an excellent directory.
Endometriosis is a chronic condition that can cause pain and infertility.
Treatment for this condition focuses on symptom relief. Hormonal medications are often enough to reduce the pain and heavy menstrual bleeding caused by endometriosis. Pregnancy can often be achieved naturally or through assisted reproductive techniques such as IVF.