How Is Endometriosis Treated?

Endometriosis can be different for everyone. Treatment for endometriosis is also customized to the person. There is no treatment that can cure endometriosis. But there are many treatment options that can reduce pain and help manage symptoms.^1,2

Pain medicines

Managing pain can be an important part of treating endometriosis. Some medicines that can help manage pain for people with endometriosis include:^1-5

• Non-steroidal anti-inflammatory drugs (NSAIDs) – NSAIDs include medicines such as ibuprofen. Lower doses can be available over the counter. Or, your doctor may prescribe a higher dose.
• Myfembree® (relugolix, estradiol hemihydrate, and norethindrone) – This is a hormonal drug that can reduce moderate to severe pain for people with endometriosis.
• Muscle relaxers/antispasmodics – These drugs work by decreasing cramping and relaxing muscles near the pelvis. Examples include Zanaflex® (tizanidine), Flexeril® (cyclobenzaprine), and hyoscyamine.
• Antidepressants or anti-anxiety drugs – These drugs can help people manage chronic pain. Examples used to treat pain include Norpramin® (desipramine) and Elavil® (amitriptyline).
• Anticonvulsant medications – These drugs are typically used to manage partial seizures. But smaller doses can help with neuropathic pain. Examples include Neurontin® (gabapentin), Lyrica® (pregabalin), and Topamax® (topiramate).
• Opioids – These medicines may be an option for some people with severe pain from endometriosis.

Hormone therapy

Changes in hormones during the menstrual cycle can worsen endometriosis symptoms. Drugs that contain or regulate hormones can help prevent this. These drugs may include:^1,2,6

• Birth control with estrogen and progestin – These might be pills, shots, patches, or rings that contain the hormones estrogen and progestin. They can help cause lighter and shorter periods.
• Birth control with only progestin – Progestin treatments can stop your period and the growth of endometriosis. These include implants, shots, pills, or intrauterine devices (IUDs).
• Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists – These medicines stop your period and lower estrogen levels in the body.
• Danazol (danocrine) – This medicine stops the hormones that cause you to have a period.

Surgery

Some people may benefit from surgery for endometriosis. Because of the risk, it is usually not the first line of treatment used. Also, while surgery can help manage pain, it may not prevent endometriosis pain from returning. Surgeries for endometriosis include:^1,2,4,7

• Laparoscopic surgery – This surgery is done using a small camera placed through a tiny hole in your abdomen. Doctors may use this surgery to view the affected tissue, or they might use a tiny tool to remove lesions.
• Laparotomy –This is similar to laparoscopic surgery, except that your surgeon makes a large cut across the abdomen. This is no longer a common surgery for endometriosis.
• Hysterectomy – This is the removal of the uterus. This is typically a last resort for endometriosis. Not everyone is a good candidate for a hysterectomy. It will depend on your condition and fertility plans.

ART for infertility treatment

Some people with endometriosis struggle with fertility. Assisted reproduction techniques (ARTs) are treatments that may help people with fertility problems become pregnant. This might include:^1-3

• Medicine that helps the ovaries make more eggs
• In vitro fertilization (IVF) – During this procedure, the eggs and sperm are mixed outside of the body and then placed back into the uterus.
• Intrauterine insemination (IUI) – This is also called artificial insemination. In IUI, a prepared sperm mixture is placed directly into the uterus.

Complementary and alternative medicine

Complementary and alternative medicine (CAM) are treatments outside the scope of standard medicine. Some CAM treatments for endometriosis include:^2,3,8

• Acupuncture
• Chiropractic care
• Herbs like cinnamon trig or licorice root
• Vitamin B1, magnesium, or omega-3 fatty acids
• Medical marijuana

Talk to your doctor if you are interested in any CAM treatments. Research on CAM treatments is limited. They also have the potential to impact other treatments you use. Your doctor can help you decide what CAM treatments may or may not be right for you.²

Other things you can do at home to manage endometriosis pain include:^2-4

• Taking a warm bath or using a heating pad to relax muscles
• Eating a healthy diet
• Staying physically active

Seeing a physical therapist may also help. They can help you relax tight muscles, which may help with endometriosis pain.²

Before beginning treatment for endometriosis, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.