Pain Relief Drugs for Endometriosis
Pain is one of the most common symptoms of endometriosis. There are many different types of drugs that can relieve pain. Some directly inhibit pain, others work by lowering inflammation and reducing the hormones that can exacerbate endometriosis. In this article, we will explore some of the more commonly used medications for endometriosis.
Analgesics (pain relieving drugs)
Common pain relievers include paracetamol (also known as acetaminophen), which helps to reduce mild to moderate pain and reduce fever. It is not fully understood how paracetamol works.
Opioids, such as codeine, are strong painkillers which can be used for severe pain. The problem with opioids is that they don’t address the underlying cause of pain and they are highly addictive; If taken regularly, over time, the dose will need to be increase. Opioids also come with other side effects, such as constipation.
Nonsteroidal anti‐inflammatory drugs (NSAIDs) are a first-line treatment for endometriosis pain. NSAIDs work by reducing prostaglandin levels in the blood. Prostaglandins are chemicals that have a range of functions within the body, one of them is to maintain the integrity of the stomach lining. Women with endometriosis have been shown to make excessive amounts of a type of prostaglandin, PGE2, which contributes to pain and inflammation.
Because NSAIDs stop the production of PGE2 that cause pain (rather than block the sensation of pain), it is important to take NSAIDs before you experience pain. NSAIDs can have serious side-effects. Because they block all prostaglandins, they can block the good prostaglandins that help support the lining of the stomach. This is why common side effects include nausea, vomiting, stomach irritation, and ulcers. Some common brand names of NSAIDs include Naprogesic, Ibuprofen and Ponstan.
It is also important to note that our diet and certain supplements can reduce PGE2, therefore lower pain and inflammation. Diet and supplements have been discussed extensively on Endometriosis.net.
Hormonal treatments are also commonly prescribed for endometriosis. Hormonal therapy can be used to suppress symptoms and ovulation.1 It is important to remember that synthetic hormones are not the same as your natural hormones and carry the risk of side-effects. Additionally, there is limited evidence supporting the most commonly prescribed hormonal therapy, the oral contraceptive pill, for the treatment of endometriosis.1
Hormonal drug examples are listed below and are extensively discussed in the article Hormonal treatments for endometriosis.
- Combined Oral contraceptive pill.
- Synthetic progesterone or progestins
- Gonadotropin-releasing hormone (GnRH)
- Aromatase inhibitors
Antidepressant drugs work by altering the levels of neurotransmitters in the body, which are chemicals that are involved in mood and can also play a role in pain. Serotonin and norepinephrine are neurotransmitters that are altered by antidepressants; both of these chemicals can inhibit pain perception.2
Commonly prescribed antidepressants are:
- Tricyclic antidepressants such as Amitriptyline (or Endep / Elavil)
- SNRI/SSRI antidepressants: such as Duloxetine
- Pregabalin (Lyrica) or Gabapentin (Neurontin)
Pregabalin and gabapentin are medications that have similar actions to the neurotransmitter GABA, which is a chemical found naturally in the body. Both medications can offer pain relief for both neuropathic pain and inflammatory pain conditions. Additionally, both of these drugs can also help reduce anxiety and improve sleep.3
There are a range of different medications available to help manage endometriosis pain. There are also new medications being tested. However, drugs usually come with side-effects, so it is important to do your research and ask your doctor questions so you can make an informed decision and can weigh up the risks with the benefits.
It is also worth noting that diet, supplements, and complementary therapies (such as mindfulness meditation or acupuncture) may also help manage endometriosis pain. So it is worthwhile trying different types of therapies to see what works for you.
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