Understanding Treatment Approaches

Endometriosis develops when tissue similar to the uterine lining grows outside the uterus, causing pain, fatigue, and sometimes infertility. While there’s no permanent cure, several treatments are available to manage symptoms and improve quality of life.

Doctors often begin with medication—like pain relievers or hormone therapy—and may recommend surgery if symptoms persist. For those struggling with infertility, in vitro fertilization (IVF) can also be an option.

Pain Relief Options

Mild endometriosis symptoms can often be managed with over-the-counter medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). For more severe cases, doctors may prescribe stronger painkillers.

It’s important to consult a healthcare provider before using NSAIDs if you have certain health conditions (heart, kidney, or liver disease) or if you are more than 20 weeks pregnant.

Birth Control and Hormonal Therapy

Hormonal treatments help regulate or suppress periods, slowing the growth of endometriosis lesions. Common methods include birth control pills, hormonal patches, vaginal rings, and intrauterine devices (IUDs).

While effective, these treatments may have side effects such as nausea, headaches, spotting, or mood changes. Symptoms often return if treatment is discontinued, so consistency is key.

GnRH Medications

Gonadotropin-releasing hormone (GnRH) agonists and antagonists lower estrogen levels, reducing the size and activity of lesions. Available as pills, sprays, or injections, these medications are usually limited to short-term use due to side effects like hot flashes, fatigue, or bone density loss.

Newer drugs, like oral GnRH antagonists (e.g., Orilissa), may offer fewer side effects, though treatment length is still restricted to prevent long-term complications.

Progesterone and Progestin

These hormone-based therapies reduce menstrual bleeding and slow lesion growth. They are available as pills, injections, or IUDs. While helpful, side effects can include weight gain, irregular bleeding, or mood changes.

Women using these therapies should still practice safe sex, as pregnancy can occur even if periods stop.

Surgical Treatments

When medications are not enough, surgery may be recommended.

• Laparoscopy: A minimally invasive procedure where small incisions allow doctors to remove or destroy lesions and scar tissue. It is considered the gold standard for both diagnosis and treatment.

• Laparotomy: A more invasive surgery, sometimes used when lesions are extensive. In severe cases, a hysterectomy (removal of the uterus) may be performed, though this does not guarantee symptom relief.

Multiple surgeries are usually avoided to protect reproductive health.

Fertility Support with IVF

For those facing infertility, in vitro fertilization (IVF) can improve the chances of pregnancy. IVF involves stimulating egg production, retrieving eggs, fertilizing them in a lab, and transferring embryos into the uterus.

While IVF helps with fertility, it does not treat pain or lesion growth, so it is usually combined with other management strategies.

Complementary Therapies

Many people explore complementary and alternative medicine (CAM) to ease symptoms. While research is still limited, some options include:

• Acupuncture: May reduce pain and inflammation.

• Massage therapy: Can help with scar tissue and tension.

• Herbal remedies: Used in traditional medicine, though effectiveness varies.

• Physiotherapy: Gentle movement and pelvic exercises to reduce pain.

Lifestyle Strategies

Lifestyle adjustments can support medical treatment and help reduce flare-ups. Useful strategies include:

• Eating an anti-inflammatory diet rich in fiber, fruits, vegetables, and omega-3 fatty acids

• Exercising regularly (e.g., yoga, swimming, walking) to reduce inflammation

• Getting enough sleep, as poor sleep can worsen symptoms and increase anxiety

• Practicing relaxation techniques like meditation or deep breathing

Living With Endometriosis

Endometriosis can be life-altering, impacting work, relationships, and mental health. Alongside physical treatment, mental health care—like counseling, CBT, or joining support groups—can provide emotional support and coping skills.

Taking a holistic approach, including medical care, lifestyle changes, and emotional support, helps people with endometriosis live fuller, healthier lives.