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Endometriosis Treatment

There is currently no cure for endometriosis, but there are:

Health care providers will consider several factors when determining the best treatment for endometriosis symptoms, including:

It is also important to note that not all treatments work well for all women with endometriosis. Similarly, there is always the chance that the endometriosis symptoms may return after the treatment is stopped or, in the case of surgery, as more time passes since the treatment.

Treatments for Pain from Endometriosis

Treatments for endometriosis pain fall into three general categories:

Pain Medications

Pain medications may work well if your pain or other symptoms are mild. These medications range from over-the-counter pain relievers to strong prescription pain relievers.

The most common types of pain relievers are nonsteroidal anti-inflammatory drugs, also called NSAIDS (pronounced ENN-sedds), and opioids (pronounced OH-pee-oyds), strong pain drugs that interact directly with the nervous system.

Evidence on the effectiveness of these medications for relieving endometriosis-associated pain is limited. Understanding which drugs relieve pain associated with endometriosis could also shed light on how endometriosis causes pain.1,2

Hormone Treatments

Because hormones cause endometriosis patches to go through a cycle similar to the menstrual cycle, hormones also can be effective in treating the symptoms of endometriosis. Additionally, our perception of pain may be altered by different hormones.

Hormone therapy is used to treat endometriosis-associated pain. Hormones come in the form of a pill, a shot or injection, or a nasal spray.

Hormone treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation. This may help slow the growth and local activity of both the endometrium and the endometrial lesions. Treatment also prevents the growth of new areas and scars (adhesions), but it will not make existing adhesions go away.

Health care providers may suggest one of the hormone treatments described below to treat pain from endometriosis3,2,4:

Researchers are exploring the use of other hormones for treating endometriosis and the pain related to it. One example is gestrinone (pronounced GES-trih-nohn), which has been used in Europe but is not available in the United States. Drugs that lower the amount of estrogen in the body, called aromatase (pronounced uh-ROH-muh-tase) inhibitors, are also being studied. Some research shows that they can be effective in reducing endometriosis pain, but they are still considered experimental in the United States. They are not approved by the Food and Drug Administration for treatment of endometriosis.8

Surgical Treatments

Research shows that some surgical treatments can provide significant, although short-term, pain relief from endometriosis,2 so health care providers may recommend surgery to treat severe pain from endometriosis. During the operation, the surgeon can locate any areas of endometriosis and examine the size and degree of growth; he or she also may remove the endometriosis patches at that time.

It is important to understand what is planned during surgery as some procedures cannot be reversed and others can affect a woman's fertility. Therefore, a woman should have a detailed discussion with a health care provider about all available options before making final decisions about treatment.

Health care providers may suggest one of the following surgical treatments for pain from endometriosis.1,2,3

In some cases, hormone therapy is used before or after surgery to reduce pain and/or continue treatment. Current evidence supports the use of an intrauterine device (IUD) containing progestin after surgery to reduce pain.6 Currently, the only such device approved by the FDA is Mirena®.

Reference: National Institute of Child Health and Human Development

Last updated April 20, 2017