Around 1 in 10 people have endometriosis — a condition marked by painful periods, painful sex, and trouble getting pregnant. Treatment options once were limited to major surgery, such as a hysterectomy. But today we have more choices than ever for managing this condition.
I’m always happy to share this information with my new patients, many of whom have struggled for years to find relief from their symptoms. So let’s take a look at what’s available — and what you and your provider can consider to help you feel your best.
Understanding endometriosis pain
Before diving into treatments, let’s talk about what’s happening in the body with endometriosis.
Endometriosis is a condition in which tissue that’s similar to the lining of your uterus grows on other parts of inside the body. These can include other areas of the pelvis, the rectum, bladder, GI tract, or even the lung.
No matter the location, these growths can wreak havoc. They can irritate nearby areas and cause scarring, fibrous tissue, and blocked fallopian tubes.
Experts don’t fully understand what causes endometriosis. Some studies suggest that it could be driven by immune system problems. Genetics could also play a role, since the condition seems to run in families. Another factor could be retrograde menstruation. That’s when menstrual blood flows backward through the fallopian tubes during your period.
Endometriosis symptoms: What to look for
Endometriosis feels different for different people. But in general, symptoms tend to be worse around your period due to cycle-related inflammation and hormone changes. You might experience things like:
- Very painful menstrual cramps
- Heavy bleeding during periods
- Spotting in between periods
- Painful sex
- Trouble getting pregnant
- Pain when going to the bathroom
- Stomach problems like constipation, bloating, or diarrhea
These issues can take an emotional toll over time. It’s not uncommon for people with endometriosis to struggle with feelings of depression or anxiety.
There’s no cure for endometriosis. However, we have many different tools for managing the condition. The right choice for you depends on how severe your symptoms are, your future pregnancy plans, your age, and other factors.
Pain relievers
Some people find relief from painful period cramps with over-the-counter drugs like ibuprofen or sodium naproxen.
Hormonal birth control
These medications can help you have lighter, less painful periods. (But they’re not for those who are planning to become pregnant in the near future.) They work by suppressing the activity of the ovaries. This, in turn, slows the growth of endometrial tissue. There are combination birth control therapies (with estrogen and progestin) or progestin-only options, depending on your needs. You can talk with your provider about different delivery methods:
- Birth control pills
- Patches
- Rings
- Shots
- Implants
- IUDs
Other hormonal options
When birth control and pain relievers don’t do enough, these can be the next steps for people who aren’t looking to get pregnant soon:
- Gonadotropin-releasing hormone (GnRH) agonists or antagonists. These drugs block estrogen, the hormones that cause your monthly periods. They’re available in oral or injectable formats.
- Aromatase inhibitors. These medicines reduce the amount of estrogen your body makes, which can also suppress your periods.
- Synthetic androgen. This hormone prevents ovulation, so your periods stop. However, it can cause side effects like weight gain or increased facial hair.
Fertility treatment
If you have endometriosis and are trying to get pregnant, fertility treatments can help. A specialist can offer therapies, including medication or in vitro fertilization. Together, you can decide on the best choice for you.
Minimally invasive surgery
Surgically removing endometrial tissue can help relieve symptoms, as well as make it easier to get pregnant. Procedures can be performed laparoscopically with a small cut in your abdomen. They can be effective in the short term. But over time, endometrial tissue can start to creep back and cause symptoms again.
Hysterectomy
In severe cases, your doctor may recommend removing your uterus and/or ovaries. It’s a major surgery that can come with serious side effects, like early menopause. And symptoms can still return. So, it’s usually only considered after other treatment options have failed.
Complementary options
Physical therapy and cognitive behavioral therapy (CBT) can help you cope with your physical symptoms. They can also support your mental health. You can use them alongside medical treatments.
Get the support you need
Temple’s OB-GYN specialists are here to listen to your concerns and help you get your symptoms under control. To learn more, call 800-TEMPLE-MED (800-836-7536) or request an appointment online.
Helpful Resources
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