Image: Endometriosis on pelvic organs
How is endometriosis treated?
The treatment of endometriosis often involves both medication (tablets and injections) and surgery (laparoscopy to remove the endometriosis). Most women who have endometriosis will require both of these treatments at different stages of their lives. The choice of treatments depends on how bad the pain is, where the pain is, and if you are trying to get pregnant.
1) Medicines:
Pain relief medication (analgesics) like naprosyn or ponstan
2)Hormone-based treatments
The oral contraceptive pill (‘the pill’)
Using an oral contraceptive to stop ovulation, the levels of estrogen in the pelvis are reduced and this can help settle the activity of endometriosis. As well, by running packets of the pill together to ‘skip’ periods, women can reduce the number of painful periods they have. It is important to realise that use of oral contraceptives will not make endometriosis go away.
Mirena
Mirena is a small device that is shaped like a T. This is placed in the uterus and releases a progesterone-like hormone. This has been shown to reduce the activity and pain of endometriosis over time for many women.
Other types of progesterone-like hormones
These medications can help settle the activity of endometriosis when used over time.
Dienogest (Vissane) is a progesterone treatment that has been shown to reduce the regrowth of endometriosis if it is taken
everyday.
GnRH-agonists
Some implants and sprays can switch off the release of reproductive hormones in women. However, this can induce a state like menopause that women may find unpleasant. It is unusual to use such medications alone for more than a few months, as there can be long-term side effects.
It is important to realise that the medications used for treatment of endometriosis are commonly contraceptive (they stop pregnancy occurring).
3) Surgery
The surgery depends on the symptoms and the location of the endometriosis. It is most often a laparoscopy. This procedure allows your surgeon to diagnose and to treat your endometriosis. The endometriosis may be cut out or burnt off.
More information about laparoscopy can be found on the RANZCOG website under Patient Information. Surgery for endometriosis can be simple or very difficult, and, if you are contemplating surgery, it is important to have a clear understanding of the nature and purpose of any surgery that is planned.