For cisgender women experiencing pain with endometriosis, the goal is to find the most suitable treatment option possible. A doctor will determine how aggressively to treat the condition based on an individual’s pain levels and stage of progression.
Over-the-counter Pain Relievers
For more mild symptoms of endometriosis, your doctor may recommend an over-the-counter pain reliever as a first-step treatment option.
Hormonal Birth Control
Hormonal birth control is often the first line of treatment for women experiencing moderate-to-severe levels of pain during menstruation or heavy menstrual bleeding. It prevents the ovaries from ovulating, which helps reduce endometriosis symptoms.
There are 4 different types of hormonal birth control:
- Birth control pills
- Hormonal IUDs (intrauterine devices)
- Progestin injection (aka, “the shot”)
Which option is best depends on the individual. While non-hormonal birth control methods—like condoms and natural family planning—can help prevent unplanned pregnancies, they won’t reduce endometriosis symptoms like hormonal contraceptive options will.
This surgical procedure is used for diagnosis as well as treatment. During treatment, a surgeon can remove lesions, which relieves endometriosis pain.
There are 2 methods for treatment:
- Ablation: Surface of endometriosis lesions is destroyed.
- Excision: Endometriosis lesions are cut out.
Gonadotropin-releasing Hormone (GnRH) Antagonist Medication
After this medication blocks GnRH receptors in the pituitary gland, the body reacts by making less estrogen. Lower estrogen levels may help to improve pain from endometriosis.
Gonadotropin-releasing Hormone (GnRH) Agonist Medications
This medication works by stimulating GnRH receptors in the pituitary gland. Over time, the stimulation causes the receptors to become less sensitive. Eventually, this desensitization leads the body to produce less estrogen, thereby helping to improve endometriosis pain.
This medication is usually an injection or nasal spray.
This surgery is generally a last-resort option because it’s complex and irreversible. A hysterectomy removes the uterus and sometimes one or both ovaries.
If endometriosis is found to affect the wall of the bowel and cause gastrointestinal (GI) symptoms, it may be necessary to remove a piece of the bowel. This surgery is uncommon and usually a last-resort option.
Some foods cause inflammation and worsen endometriosis symptoms in certain people. Therefore, on top of avoiding pro-inflammatory foods, it may be beneficial to add foods that are considered anti-inflammatory. For best results, patients must work with a registered dietitian who can individualize a diet based on their needs.
Below are some examples of anti-inflammatory foods, according to Slu Care Physician Group.
Whole grains can have added fiber to help reduce spikes in blood sugar and prevent pro-inflammation.
(Recommend 3-5 servings/day)
Nuts and Seeds
Nut and seeds contain Omega-3s which are anti-inflammatory.
(Recommend 1-2 servings/day)
Cold-pressed Vegetable Oils
Oils like extra-virgin olive oil, vegetable oil, canola oil, flaxseed oil, and nut-based oils contain Omega-3s and antioxidants that can help reduce inflammation.
(Recommend 2-4 teaspoons/daily)
Fruits and Vegetables
Fruit and vegetables naturally have antioxidant and anti-inflammatory properties.
(Recommend 1-2 servings/day for fruit and 4-5 servings/day for vegetables)
Fish and Seafood
Certain fish like Alaskan salmon, herring, sardines, and black cod are rich in Omega-3s which are anti-inflammatory.
(Recommend 3-5 servings/week)
Low-fat Dairy or Dairy Alternatives
Dairy products—like low-cheeses, yogurt, cottage cheese, skim or 1/% milk—contain vitamin D, which may aid in reducing pro-inflammatory cytokines.
(Recommend 3 servings a day)
Some simple recommendations to alleviate endometriosis pain include:
- Rest, relax, and meditate
- Take warm baths
- Prevent constipation
- Get regular exercise
- Use a hot water bottle or heating pad on your abdomen
Can endometriosis be cured?
Unfortunately, there are numerous treatment options but currently no cure for this condition.
What happens if endometriosis is left untreated?
Treating endometriosis is a difficult decision for many women. If left untreated, however, most symptoms continue and sometimes get worse.
How can you treat endometriosis without surgery?
The non-surgical treatment options include:
- oral pills,
- nasal spray,
- injections, and
- nutritional management.
You should work with your medical provider to come up with a treatment plan that best suits you.
How serious is endometriosis?
The seriousness of endometriosis will vary for every person. Typically, endometriosis is not a life-threatening disease but the pain levels can be severe. This pain can affect someone’s quality of life. In these cases, proper treatment can help.