Treatments & Drugs
The most common treatments for endometriosis are medication or surgery. The approach chosen depends upon the severity of symptoms and if you wish to eventually become pregnant. Doctors tend to recommend more conservative treatments first.
An over-the-counter pain reliever containing ibuprofen can help ease painful cramps, but if the maximum dosage doesn't provide relief, another treatment approach may be required.
Supplemental hormones can reduce or eliminate the pain of endometriosis. This is because the changes in hormones during the menstrual cycle causes endometrial tissues to thicken, dissolve and then bleed.
Hormonal therapies can include:
Birth control pills. Contraceptives tend to help control the hormones responsible endometrial tissue buildup each month, resulting in a lighter and shorter menstrual cycle. This can significantly reduce pain.
Danazol. Blocks the production of ovarian-stimulating hormones, prevents menstruation and suppresses the growth of the endometrium. Side effects can include acne and facial hair.
Gn-RH - Gonadotropin-releasing hormone agonists and antagonists. Blocks production of ovarian-stimulating hormones, preventing menstruation and lowering estrogen levels. This causes endometrial tissues to shrink and in some cases go into remission. However it is like an artificial menopause that sometimes causes troublesome side effects like hot flashes, changes in mood and vaginal dryness. A low dose of estrogen or progestin may decrease such side effects.
Aromatase inhibitors. Can reduce pain. Side effect can be bone loss and follicular cysts, so these inhibitors must be taken with an oral estrogen-progestin contraceptive or a Gn-RH agonist.
Medroxyprogesterone - Depo-Provera. Halts menstruation and the growth of endometrial tissues. Side effects can include weight gain, depressed mood and decreased bone production.
Hormonal therapies aren't a permanent solution, and it's possible you could experience a recurrence of symptoms when treatment is stopped.
If you have painful endometriosis but still want to become pregnant, surgery to remove endometrial tissue and implants can help. Surgery will remove endometrial growths, adhesions and scar tissue without affecting reproductive organs. Surgery may be laparoscopic or abdominal. In laparoscopic surgery, a laparoscope (viewing instrument) is inserted through a small incision by the navel. The doctor then inserts the needed instruments through another small incision and removes the endometrial tissue.
In severe endometriosis cases of endometriosis, a total hysterectomy may be required. This surgery will remove the uterus, the cervix and both ovaries. Hysterectomy is typically considered a last resort, especially for women who are in reproductive age range.