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Treatments for endometriosis

The cause of endometriosis remains unknown. A treatment which fully cures endometriosis has yet to be developed, and there is no overwhelming medical evidence to support one specific type of treatment for endometriosis over another [1].

Chosing a treatment therefore comes down to the individual woman's needs, depending on her symptoms, her age, and her fertility wishes. She should discuss these with her physician so that they, together, can determine, which long term, holistic, treatment plan is best for her individual needs [2].

For many women, this can be a combination of more than one treatment over longer periods of time.

For infertility please see: Endometriosis and infertility

Pain killers

Pain is the most common symptom for many women with endometriosis.

Pain killers include:

  • simple analgesics (ie. aspirin and paracetamol)
  • compound analgesics (a combination of either aspirin or paracetamol)
  • mild narcotics (ie. codeine)
  • narcotic analgesics (similar to morphine)
  • non-steroidal anti-inflammatory drugs (ie. nurofen, ponstan, voltaren, etc).

More about how to use painkillers

Hormonal therapies

Endometriosis is exacerbated by oestrogen. Therefore, hormonal treatments for endometriosis are designed to attempt to temper oestrogen production in a woman's body and such treatments may subsequently relieve her of symptoms.

Hormonal therapies may include:

The combined oral contraceptive pill (OC)

Progestogens | progestins

Mirena (IUD)

GnRH-analogues (agonists and antagnosists)

Danazol

Aromatase inhibitors

Hormonal therapies have varying degrees of side effects and, unfortunately, whatever pain relief that is achieved may be only temporary for many girls and women.

TIPS for dealing with side effects associated with drug treatments

 

Surgery

Laparoscopic surgery is the only definitive way to diagnose endometriosis [1]. In many cases, the disease can be diagnosed and treated in the same procedure.

The success of surgery depends greatly on the skill of the surgeon and the thoroughness of the surgery [2]. The aim is to remove all endometriotic lesions, cysts, and adhesions.

Today, most endometriosis surgery is being done through the laparoscope, although a full abdominal incision called a laparotomy may still be required in rare cases for extensive disease or bowel resections.

Laparoscopic surgery

Chosing a specialist

Although women with endometriosis are often told that hysterectomy is the “definitive” solution for endometriosis, the disease can recur even after a hysterectomy. Hysterectomy may be a very good solution for some women with endometriosis, but do know your facts before deciding on this option.

More about hysterectomy

Nutritional therapy

The correct balance of daily nutrients are essential for all of us. Proper nutrition helps improve our general health.

For a woman with endometriosis it may also increase her ability to tolerate medical treatments, increase her ability to deal with potential side effects of treatment, increase her energy, and enhance her ability to think clearly. Nutritionists can work with women and girls with endometriosis to put together an appropriate dietary plan.

More about dietary modification to alleviate endometriosis symptoms

Complementary therapies

Given the chronic and stubborn nature of endometriosis, there may be times when it is beneficial to explore therapies beyond the medical mainstream.

Whilst there is no clinical evidence as to the effectiveness of these therapies, many women with endometriosis have had good symptom relief by using homeopathy, osteopathy, herbs, and Traditional Chinese Medicine (TCM).

Physiotherapists (physical therapists) can develop a programme of exercise and relaxation techniques designed to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety. After surgery, rehabilitation in the form of gentle exercises, yoga, or Pilates can help the body get back into shape by strengthening compromised abdominal and back muscles.

ESHRE Guideline on coping therapies

 
A multi-disciplinary approach - coping long term

To provide holistic treatment to women and girls with endometriosis, a team of medical professionals may be involved in providing care, including:

- general practitioners
- gynaecologists
- surgeons (from a number of disciplines)
- reproductive endocrinologists
- immunologists
- nutritionists/dieticians
- nurses
- psychologists
- counsellors
- pain specialists
- physiotherapists
- national support organisations

All of these disciplines can play an important role in providing an individualised treatment plan for a woman or girl with endometriosis.

See also: Multi-disciplinary centres/networks of excellence for endometriosis management

Finally, please remember that endometriosis affects more than just the physical body. It may affect women and girls in profound emotional ways as well. Psychologists and counsellors can play an important role by helping women and girls cope with the feelings of confusion, disbelief, chronic pain, infertility, and frustration that often accompany this disease.

See also: Families and partners of those with endometriosis

Support groups also play a vital role in learning to cope with endometriosis and may be able to provide information about national or regional centres, who specialise in the treatment of endometriosis.

 
Refererences

 

1. ESHRE guideline for the diagnosis and management of endometriosis
Kennedy et al Human Reprod 2005;20(10):2698-2704.

2. Multi-disciplinary centres/networks of excellence for endometriosis management and research: a proposal
D'Hooghe T and Hummelshoj L. Hum Reprod 2006;21(11):2743-8.

 

See also


Finding a centre of excellence/endometriosis specialist

Endometriosis surgery

Preparing for your first endometriosis consultation [English|Español]

Tips on talking with your doctor

Coping with endometriosis

ESHRE guideline for the diagnosis and treatment of endometriosis

Infertility resources