Surgery, home remedies and more
There is currently no cure for endometriosis. Treatment focuses on relieving pain and preventing infertility. Potential treatments range from oral medications like birth control pills to surgical solutions like laparoscopy. There are even alternative therapies for endometriosis.
To determine the best treatment for you, your doctor will consider factors such as your:
- pain level
- desire to become pregnant
- general health
Endometriosis is a chronic (long-term) condition that can affect anyone with a female reproductive system. It occurs when endometrial tissue (the tissue that lines the uterus) grows outside the uterus where it doesn’t belong. Pain, which ranges from mild to debilitating, is the most common symptom.
If you have endometriosis, the endometrial tissue that grows outside your uterus is affected by the same hormonal changes that trigger menstruation. It gets thicker during your cycle and then breaks down and bleeds. This can lead to inflammation.
Scar tissue and adhesions can accumulate over time, which can affect fertility.
Medications, both prescription and over-the-counter (OTC) drugs, can reduce inflammation and relieve pain. If your pain levels are low, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil/Motrin) and naproxen (Aleve) may be all you need to control your pain.
However, many people need additional medications or treatments to improve their quality of life. Medications used to treat endometriosis include:
birth control pills
Medications that help regulate hormones, such as birth control, are among the most common endometriosis treatments. They help relieve the pain and cramps that come with your period. They can also prevent new adhesions and scar tissue from forming.
Hormonal birth control pills work because they help regulate and stabilize estrogen and progesterone levels. When your hormones don’t surge, the endometrial tissue doesnot thicken and cause inflammation.
Many birth control pills are only taken 21 days a month, followed by 7 days of placebo (sugar) pills. For endometriosis, doctors often recommend a continuous cycle option without placebo pills. Eliminating the placebo days keeps hormone levels even more stable.
Birth control pills usually shorten and lighten your period. Continuous pills can also be used to reduce the number of periods you have each year or stop them entirely.
Birth control pills are a good option for people planning to become pregnant in the near future as they are easy to come off.
IUDs and other hormonal contraceptives
Hormonal birth control only reduces endometriosis symptoms while you are using it. If you stop taking it (or forget to take your pill regularly), your symptoms will most likely come back.
For a more reliable, long-term solution, you may want to consider other hormonal contraceptives. Progestin-containing IUDs like Mirena are a good option.
Hormone IUDs work in the same way as birth control pills to prevent endometrial tissue from thickening. They can reduce cramps and make your period much lighter. Some people stop getting their periods altogether.
IUDs last for several years and can be removed if you decide to become pregnant.
Other hormonal birth control options include:
GnRH (gonadotropin-releasing hormone) agonists
GnRH agonists prevent your ovaries from producing estrogen. This stops ovulation, menstruation, and the hormonal cycle that makes endometriosis worse.
GnRH agonists are available as a nasal spray or injection. They are also available in pill form.
These drugs can cause many of the uncomfortable side effects that are common during menopause, including:
They can also lead to bone loss and other complications when taken long-term.
Danazol is a synthetic steroid that mimics testosterone, a male reproductive hormone. This drug, taken in pill form, prevents ovulation. You may have very few or no menstrual cycles while taking this medication.
Danazol can cause “masculinization” side effects such as: B. a deepening of your voice. It can also harm a developing fetus. You should not take this medication if you are pregnant or might become pregnant.
Endometriosis surgery can be performed both to confirm a diagnosis and to treat the disease.
The benefits of surgery can be temporary or permanent. Before agreeing to any procedure, talk to a doctor about your desire for a future pregnancy. Some procedures increase the chance of pregnancy. Others eliminate your ability to conceive and carry a baby.
A laparoscopy is a minimally invasive surgical procedure that allows your doctor to look inside your abdomen with a tiny camera. It is the gold standard for diagnosing endometriosis. It can also be used to treat the disease.
During a diagnostic laparoscopy, a small incision is made in your abdomen and a thin tube with a camera on the tip is inserted. This allows your doctor to see how far advanced your endometriosis is.
As your surgeon proceeds with the treatment, he or she will remove excess tissue through another small incision. They can also destroy scar tissue and adhesions.
Removing this tissue can make it easier for you to conceive. It can also reduce your pain level.
Laparoscopy may be a good option for you if your symptoms don’t improve with medication alone. It is not a cure for endometriosis. Endometrial tissue often grows back over time.
Other surgical options
Other surgical treatments for endometriosis are much more aggressive. For this reason they are notnot as common as it used to be. Examples include:
- Laparotomy. This major surgical procedure is sometimes performed to remove endometrial and scar tissue. Because these are major cuts and a full recovery, this is not common.
- Hysterectomy. This is the surgical removal of the uterus. While it can ease pain in those who don’t plan on bearing children, it can have adverse health consequences in younger people.
- oophorectomy. This is the surgical removal of the ovaries. It can help improve symptoms, but it leads to an early menopause. Early menopause comes with its own health risks.
Some people with endometriosis have trouble conceiving. Patches of endometrial tissue can:
- block the fallopian tubes
- damage the ovaries
- change the pelvic environment
For many people, a laparoscopy with tissue removal is enough to restore fertility. If you don’t get pregnant after surgery, your doctor may recommend additional fertility treatments.
Fertility Drugs and IUI
Fertility drugs such as clomiphene and gonadotropins are sometimes used to stimulate the ovaries. They stimulate ovulation and help prepare the body for pregnancy. Clomiphene is taken as a pill for about 5 days during each cycle, while gonadotropins are taken by injection.
In people with advanced endometriosis, fertility drugs are often combined with intrauterine insemination (IUI).
IUI is a type of artificial insemination performed in a doctor’s office. Using a sample of semen from a partner or donor, your doctor places the sperm directly into your uterus.
In Vitro Fertilization (IVF)
IVF is a form of assisted reproductive technology designed to help you get pregnant. The process involves many steps, including:
- Taking hormonal medications that help you produce lots of eggs.
- Have your eggs removed through a small outpatient procedure called egg retrieval.
- An embryo is placed directly into your uterus using a dropper during a procedure called embryo transfer.
Because menstruation stops during pregnancy, many people experience relief from pain and other endometriosis symptoms during this time. After childbirth, your symptoms may return.
You may be able to relieve the pain of endometriosis with alternative therapies. Ask a doctor about natural remedies you are considering. In some cases, they may be compatible with medical treatments that you are already receiving. In other cases, they can be contradictory.
Natural remedies for endometriosis may include:
- Acupuncture. A
review of studiespoints out that acupuncture can reduce the pain caused by endometriosis. Although more research is needed, studiesalso indicate that acupuncture improves IVF outcomes.
- Anti-Inflammatory Diet. Because endometriosis causes inflammation, avoiding foods like red meat and sticking to an anti-inflammatory diet can be beneficial.
- Massage. A type of massage therapy called osteopathic manipulative therapy can help relax the pelvic muscles and reduce pain. It can also be beneficial for reducing inflammation.
Treat endometriosis at home
Home remedies can relieve your symptoms. Examples include:
- NSAIDs. Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil/Motrin) can reduce pain and swelling.
- The exercise. Exercising regularly has many benefits, including relieving stress, aiding in pain management, and reducing inflammation.
- Heat. Try putting a hot water bottle or heating pad on your stomach.
- Meditation. Meditation helps reduce stress and improve pain management.
- Tea. Drinking teas with anti-inflammatory properties like ginger and turmeric can help.
You don’t have to live with endometriosis pain. Have an open conversation with a doctor you trust about your quality of life and what you are going through. When people are too embarrassed or embarrassed to discuss certain symptoms with their doctor, they are not getting the treatment they need.
Keep in mind that doctors haven’t done a great job of treating women’s pain in the past. If your doctor doesn’t take your symptoms or concerns seriously, find an empathetic gynecologist who does. The American College of Obstetricians and Gynecologists has a great directory.
Endometriosis is a chronic condition that can cause pain and infertility.
Treatments for this condition focus on relieving symptoms. Hormonal medications are often sufficient to relieve the pain and heavy menstrual bleeding caused by endometriosis. Pregnancy can often be achieved naturally or through assisted reproductive techniques such as IVF.