How to Treat Endometriosis: Surgery, Home Remedies & More – Healthline

Currently, there is no cure for endometriosis. Treatment focuses on alleviating 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 help determine the best treatment for you, your doctor will consider factors such as your:
Endometriosis is a chronic (long-term) disorder that can affect anyone with female reproductive organs. It occurs when endometrial tissue (the tissue that lines the uterus) grows outside of the uterus, where it doesn’t belong. Pain, ranging from mild to debilitating, is the most common symptom.
When you have endometriosis, the endometrial tissue growing outside your uterus is affected by the same hormonal changes that bring on menstruation. It grows thicker throughout your cycle and then breaks down and bleeds. This can lead to inflammation.
Over time, it can cause a buildup of scar tissue and adhesions that may interfere with fertility.
Medications, both prescription and over-the-counter (OTC) medications, can reduce inflammation and provide pain relief. If your pain level is low, OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil/Motrin) and naproxen (Aleve) may be all you need to control your pain.
But many people need additional medications or treatments to help improve their quality of life. Medications used to treat endometriosis include:
Medications like birth control that help regulate hormones are among the most common endometriosis treatments. They help reduce the pain and cramping that happen around your period. They may also prevent the formation of new adhesions and scar tissue.
Hormonal contraceptives work because they help regulate and stabilize estrogen and progesterone levels. When your hormones don’t spike, endometrial tissue doesn’t grow thicker 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 typically shorten and lighten your periods. Continuous-cycle pills can also be used to reduce the number of periods you have annually or to stop them completely.
Birth control pills are a good option for people who plan on getting pregnant in the near future, as they can be easily discontinued.
Hormonal birth control only reduces endometriosis symptoms while you’re using it. If you stop using it (or forget to take your pill regularly), your symptoms will most likely come back.
For a more dependable, long-term solution, you may want to consider other hormonal contraceptives. IUDs that contain progestin, such as Mirena, are a great option.
Hormonal IUDs work the same way as birth control pills to stop endometrial tissue from thickening. They can reduce cramps and make your period much lighter. Some people stop getting their period altogether.
Hormonal IUDs last for several years and can be removed if you decide to get pregnant.
Other hormonal contraceptive options include:
GnRH agonists prevent your ovaries from making estrogen. This stops ovulation, menstruation, and the hormonal cycle that exacerbates endometriosis.
GnRH agonists are available as a nasal spray or injection. They are also available in pill form.
These medications can cause many of the unpleasant side effects common during menopause, including:
They can also lead to bone loss and other complications if taken long term.
Danazol is a synthetic steroid that mimics testosterone, a male reproductive hormone. This drug, taken in pill form, stops ovulation from occurring. You may have very few or no menstrual cycles while you’re on this drug.
Danazol may cause “masculinization” side effects, such as a deepening of your voice. It can also harm a developing fetus. You should not take this medication if you are or might become pregnant.
Endometriosis surgery can be done to both confirm a diagnosis and treat the disease.
The benefits of surgery may be temporary or permanent. Before you consent to any procedure, talk with a doctor about whether you have a desire for future pregnancy. Some procedures will make pregnancy more likely to occur. Others will eliminate your ability to conceive and carry a baby.
A laparoscopy is a minimally invasive surgical procedure that allows your doctor to see 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 at its tip is inserted into it. This allows your doctor to see how advanced your endometriosis is.
If your surgeon chooses to proceed with treatment, they will remove excess tissue through another small incision. They may also destroy scar tissue and adhesions.
Removing this tissue may make it easier for you to conceive. It may 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 treatments for endometriosis are much more aggressive. For this reason, they aren’t as common as they used to be. Examples include:
Some people with endometriosis have difficulty becoming pregnant. Patches of endometrial tissue can:
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 medications, like clomiphene and gonadotropins, are sometimes used to stimulate the ovaries. They encourage 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 more 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 sperm sample from a partner or donor, your doctor will place the sperm directly into your uterus.
IVF is a form of assisted reproductive technology designed to help you get pregnant. The process involves many steps, including:
Since menstruation stops during pregnancy, many people experience relief from pain and other endometriosis symptoms during this time. Once you deliver, your symptoms may return.
You may be able to reduce the pain of endometriosis through alternative therapies. Ask a doctor about any natural remedies you’re considering. In some instances, they may be compatible with medical treatments you’re already having. In other instances, they may conflict.
Natural remedies for endometriosis may include:
Home remedies may reduce your discomfort. Examples include:
You don’t have to live with endometriosis pain. Have an open dialogue with a doctor you trust about your quality of life and what you’re going through. When people feel too embarrassed or awkward to discuss certain symptoms with their doctors, they don’t get the treatment they need.
Keep in mind, historically, doctors have not done a great job handling women’s pain. If your doctor isn’t taking your symptoms or concerns seriously, find an empathetic gynecologist who will. 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 center on symptom relief. Hormonal medications are often enough to reduce the pain and heavy menstrual bleeding caused by endometriosis. Pregnancy can often be achieved naturally or through assisted reproductive technologies such as IVF.
Last medically reviewed on March 31, 2022
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