Treating Endometriosis

In many cases, endometriosis can be successfully managed; however, there is no cure for the condition. The primary aim of treatment is to ease symptoms, improve the daily life of the sufferer and, if desired, to help her get pregnant. The treatment you will be offered will depend upon the severity of your symptoms, the location of the endometrial tissue within your body and your plans for pregnancy, among other factors. The most common treatment for mild to moderate symptoms is pain-killing medication. Hormone-based drug treatments may be used to stop the production of hormones within your body which exacerbate the problem. If infertility or "sub-fertility" is a problem for you, you may also be offered surgery to remove any endometrial tissue which may be interfering with your reproductive system. All these treatments have their advantages and disadvantages, and potential side effects. You will have to work together with your gynaecologist to find the right treatment, or combination of treatments, for you. No treatment at all is also an option for very mild cases. Approximately 1/3 of women with endometriosis find their symptoms improve without treatment.

Pain Killers

Non-steroidal inflammatories (NSAIDS) such as Ibuprofen can help reduce the swelling, pain and general discomfort of endometriosis, providing the symptoms are not too severe. However, due to certain side effects, not everyone can take NSAIDS, so other pain killers such as Paracetamol or Codeine may be used.

Hormone Treatment

Four main types of hormone-based drug treatment are used to relieve the symptoms of endometriosis. All of them help to stop your natural oestrogen production. The hormone oestrogen encourages the growth of endometriosis. The drugs prevent this by tricking your body into thinking it's in a state of menopause or pregnancy. This stops your periods and the monthly fluctuations of oestrogen which come with them. This prevents your endometriosis being aggravated throughout each menstrual cycle. The four types of treatment are as follows:

Progestogens - these drugs stop ovulation and shrink endometrial tissue.

Anti-progestogens - also known as testosterone derivatives, these drugs bring on an artificial state of menopause by decreasing the body's natural oestrogen and progesterone production.

Combined oral contraceptive pill - these drugs are not an officially licensed treatment for endometriosis, however, they do help to relieve mild symptoms by stopping ovary function and therefore suspending the natural menstrual cycle.

Gondatrophin-releasing hormone analogues (GnRH) - these drugs also stimulate menopause by stopping oestrogen production. They are often combined with hormone replacement therapy (HRT) to combat their side effects.

All of the above hormone treatments have potential side effects.

Surgery

Particularly if you are hoping to get pregnant, you may be offered surgery to remove endometrial tissue that is interfering with your reproductive system or causing you pain. The type of surgery recommended will depend of the location of the endometrial tissue in your body. For milder cases, keyhole surgery, laparoscopy or laser surgery may be offered. In more extreme cases where pregnancy is not an issue, a hysterectomy (the complete or partial removal of the uterus and other reproductive organs) may be performed. It is, however, very difficult to remove all endometrial tissue in one go, which means that even after surgery, symptoms may recur. If you would like to know more, check out our information on surgery for endometriosis.

A Word Of Caution

It's important to be aware that although all of the hormonal treatments mentioned above will stop your periods, the contraceptive pill is the only one that will definitely protect you against pregnancy. You may find that you have to persevere for several menstrual cycles with any treatment recommended by your gynaecologist before you see an improvement. You may even have to work out a combination of different treatments which will improve your quality of life and, if you want, help to you to have a baby.