HealthInfo Waitaha Canterbury

Treating endometriosis

Currently there is no cure for endometriosis. Treatments aim to:

• reduce and control your symptoms
• improve your quality of life
• slow down the disease
• help protect your fertility.

Before deciding on a treatment, you and your doctor will need to consider:

• your age
• how bad your symptoms are
• whether you are able to, or want to, have children
• any previous treatment you've had and how effective it's been.

Treatment options include pain relief, hormone treatment, and surgery.

You usually get the best outcomes by working with health professionals, along with self-care and lifestyle changes.

Self-care and lifestyle changes

Staying a healthy weight, eating well, being active, reducing stress, and stopping smoking can improve your symptoms. You could also try cutting down on caffeine and alcohol.

Using heat, such as from a hot water bottle, may help reduce discomfort.

Pain medication

Pain medications, especially anti-inflammatories such as mefenamic acid, ibuprofen, naproxen (te reo Māori version) and diclofenac, help to reduce inflammation and pain. Taking them regularly, with or without paracetamol, may be particularly useful.

Hormone treatment

Hormone treatment acts on the lining of your womb to reduce the growth of endometriosis. It can take a few months before hormone treatment works as well as it can. It comes in several forms.

Combined oral contraceptive pill (the Pill)

The Pill contains a mixture of estrogen and progesterone. It stabilises your hormone levels and stops your ovaries from releasing eggs (ovulating). This makes the uterus lining thinner and makes periods lighter and shorter.

Progestogens

Progesterones help by suppressing the growth of endometriosis tissue. Commonly used progesterones include:

• tablets such as Cerazette, Provera, norethisterone
• hormonal intrauterine device (IUD) – This is a small plastic T-shaped device that is placed inside your womb (uterus). It slowly releases progesterone over a period of 5 years. This helps thin the lining and partially suppresses the ovaries from releasing eggs. This can make your periods lighter and less painful.

If these treatments do not help with your symptoms, your doctor may refer you to a specialist doctor (gynaecologist). Specialist treatments may include medicines such as Zoladex or leuprorelin. If none of these treatments work for you, surgery may be an option.

  HealthInfo recommends the following pages

• Endometriosis NZ – Managing endo

  Treatment options and tips for managing the physical and emotional symptoms of endometriosis.

• NICE UK – Hormone treatment for endometriosis symptoms – what are my options?

  This decision aid can help you decide about hormone treatment to try to control your endometriosis symptoms.

On the next page: Surgery for endometriosis

Written by GP liaison, Christchurch Women's Hospital. Adapted by HealthInfo clinical advisers. Last reviewed September 2021.

Sources

Image courtesy of Areeya at Free DigitalPhotos.net

Page reference: 278803

Review key: HIEND-30280