Endometriosis is usually treated with medication or surgery. You and your doctor will decide on the plan of action based on your unique circumstances, the severity of your signs and symptoms and whether you hoping to become pregnant in the future. Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort.
For me we immediately decided on surgery, which I don’t regret for a second. Since the laparotomy the pain became less and I am not so bloated anymore and there are no irregular bleeding. And no problems with sex. After the laparotomy I was on hormone suppressing medication for 6 months to give the scarring chance to heal. Xoladex, which is the same injections they give to breast cancer patients. I have also been on the contraceptive Yaz since the first laparoscopy. And my doctor is really impressed each year when I go for my checkup about how well Yaz keeps everything in control.
In general the treatment options are as follows:
- Pain medications: Over-the-counter pain relievers are usually the first thing you grab at to help ease the painful menstrual cramps. For me just normal painkillers didn’t work (Panado, Disprin, etc.), it had to contain ibuprofen (any nonsteroidal anti-inflammatory drugs like GenPayne, myPaid, etc.). This only helps managing the pain and increase your quality of life as you might feel better about getting through the day.
- Hormone therapy: Sometimes supplemental hormone are effective in reducing or eliminating the pain.It could also slow endometrial tissue growth and prevent new implants of endometrial tissue. It is not a permanent fix and the symptoms might return after stopping treatment. Hormonal therapy can include any of the following:
- Hormonal contraceptives – may reduce or eliminate the pain of mild to moderate endometriosis
- Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists – create an artificial menopause. Your periods and the ability to get pregnant return when you stop taking the medication.
- Progestin therapy – such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants
- Danazol – may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.
- Surgery: this is usually the option if you plan on becoming pregnant one day. The surgeon will remove as much of the endometriosis as possible. However the endometriosis and pain might return.
- Assisted reproductive technologies: IVF (in vitro fertilization) is usually suggested for endometriosis patients who wants to attempt pregnancy.
- Hysterectomy: This is only suggested for the most severe cases and considered the very last resort, especially for woman still in their reproductive years
Finding a doctor with whom you feel comfortable is crucial in managing and treating endometriosis. You may also want to get a second opinion before starting any treatment to be sure you know all of your options and the possible outcomes.