Treating Endometriosis

The tissue that lines your uterus is called the endometrium. Endometriosis is growth of this tissue in abnormal places, often outside the uterus. These growths are called endometrial implants. During the menstrual cycle, the endometrium swells. Any implants will swell too. This can cause symptoms such as pain. The condition can also cause trouble getting pregnant. But endometriosis can be treated. Hormones and surgery are the 2 most common options. Talk with your healthcare provider about what treatment plan is best for you.

Medical therapy

You and your healthcare provider may decide that medicine is the best treatment for you at this time.

Estrogen and progesterone are the main hormones that control your menstrual cycle. Medicines can help control these hormones. This helps limit the swelling of all endometrial tissue. This treatment may be tried instead of surgery. Or it may be used along with surgery. Some medical therapy prevents a woman from becoming pregnant. Common types of medical therapy include:

GnRH agonists. These hormones stop the body from making estrogen. They help with pain and may be used with low doses of other hormones to help prevent side effects.
Birth control pills. These prevent the hormone levels from changing as they would during a normal menstrual cycle.
Progestins. These are a form of progesterone. They help keep estrogen levels low.
Danazol. This is a weak male hormone. It stops or lowers a woman’s production of estrogen and progesterone. This is less commonly used. A nonhormonal form of birth control must be used with this therapy.
Nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines help with pain, but they do not treat the endometriosis.

Surgery

If medical therapy does not control the problem, surgery can be done. During surgery, endometrial implants may be removed. This may help people get pregnant if the endometriosis was causing fertility problems. If a person does not want to get pregnant, in some cases, the uterus may be removed. This is called a hysterectomy. The ovaries may be removed along with the uterus. There are 2 methods for doing surgery:

Laparoscopy. This is surgery done through small cuts (incisions) in your stomach. A thin, lighted tube called a laparoscope is used. It is put through 1 of the small incisions. Surgical tools are put through the other small incisions.
Laparotomy. This is surgery done through 1 larger incision in your stomach. It is used to remove large implants that can’t be reached with the laparoscope. It may also be used when pelvic organs, such as your bowel, are affected.