Treatment

Acupuncture Allergies Alzheimer's Disease Androgen Anxiety Disorders Asthma Atherosclerosis Attention Deficit Hyperactivity Disorder Bacterial Vaginosis Biofeedback Bipolar Disorder Birth Control Pills Blood Donation and Transfusion Breast Augmentation and Reduction Breast Cancer Breastfeeding Breast Reconstruction Caregiving Cervical Cancer Chiropractic Chlamydia Cholesterol Chronic Fatigue Syndrome Clinical Trials Colon Cancer Contraception Depression Diabetes Dry Eye Syndrome Eating Disorders Endometriosis Epilepsy Estrogen Fibroids Fibromyalgia Fitness Flu/Colds Gastroesophageal Reflux Disease (GERD) Genetic Testing Genital Herpes Glaucoma Gonorrhea Health Insurance Heart Disease Hepatitis High Blood Pressure HIV/AIDS Homeopathy Human Papillomavirus Hypnosis Hysterectomy Incontinence Infertility Irritable Bowel Syndrome Legal Health Tools Liposuction Lung Cancer Lupus Macular Degeneration Medication Safety Menopause Menstrual Disorders Metabolic Syndrome Migraine Multiple Sclerosis Naturopathy Nonsurgical Aesthetic Procedures Nutrition Obesity Ocular Allergies Oral Health Osteoarthritis Osteopathic Medicine Osteoporosis Ovarian Cancer Overactive Bladder Pain Management Pelvic Organ Prolapse Pelvic Pain Peripheral Arterial Disease Polycystic Ovary Syndrome Pregnancy Premenstrual Syndrome Preparing for Surgery Progesterone Rheumatoid Arthritis Schizophrenia Scleroderma Sexual Dysfunction Sinusitis Sjogren's Syndrome Skin Cancer Skin Health Sleep Disorders Smoking Stress Stroke Substance Abuse Tai Chi Teen Health Thyroid Disorders Trichomoniasis Urinary Tract Conditions Urinary Tract Infection Uterine Cancer Varicose Veins Violence Against Women Vulvodynia Weight Management Yeast Infections Yoga

There is no cure for endometriosis. However, there are a number of options available for treating and managing the disease after diagnosis. They fall into four categories: medical, surgical, alternative treatments and pregnancy.

1. Medical. The most common medical therapies for endometriosis are nonsteroidal anti-inflammatories (NSAIDs), hormonal contraceptives (in oral, patch, or injectable applications) and other hormonal regimens, such as GnRH agonists (gonadotropin-releasing hormone drugs).

• Non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen, are often the first step in controlling endometriosis-related symptoms. They may be used indefinitely to manage symptoms, in part because they are cheaper and easier to use than other options, and have fewer side effects than hormonal treatments. They are more effective when taken on a regular basis. Other pain relievers may be prescribed if NSAIDs are not effective.

• Contraceptive hormones (birth control pills). This option also costs less and has fewer side effects than other hormonal treatment options and may be recommended soon after diagnosis. Birth control pills stop ovulation, thus suppressing the effects of estrogen on endometrial tissue. If the pain fails to respond to oral contraceptives within three months, your health care professional should try another treatment.

• Medroxyprogesterone (Depo-Provera). This injectable drug, usually used as birth control, effectively halts menstruation and the growth of endometrial tissue, relieving the signs and symptoms of endometriosis. Side effects include weight gain, depressed mood and abnormal uterine bleeding (breakthrough bleeding and spotting).

• Gonadotropin Releasing Hormone Drugs (GnRH agonists), including leuprolide (Lupron), nafarelin (Synarel) and goserelin (Zoladex) are other hormonal treatments used to treat endometriosis. They temporarily relieve the condition by blocking the estrogen production that stimulates its growth.

  However, they have some side effects, including menopausal symptoms like hot flashes, vaginal dryness and bone loss. Hormone therapy, a combination of estrogen and progestin hormones, is typically prescribed along with GnRH agonists to alleviate these side effects.

• Androgen. This reproductive hormone, available as danazol (Danocrine) is also used to treat endometriosis. It works by suppressing ovarian function, which makes endometrial tissue inactive. A woman taking danazol will no longer ovulate or get her period. Side effects may include weight gain, hair growth, and acne, among others, some of which are reversible. Danazol is typically given for six to nine months at a time.

2. Surgical.

The goal of any surgical procedure should be to remove endometrial tissue and scar tissue. Hormonal therapies may be prescribed together with the more conservative surgical procedures.

Surgical treatments range from removing the endometrial tissues via laparoscopy to removing the uterus, called a hysterectomy, often with the ovaries (called an oophorectomy). Surgery classified as "conservative" removes the endometrial growths, adhesions and scar tissue associated with endometriosis without removing any organs. Conservative surgery may be done with a laparoscope or if necessary, through an abdominal incision.

• Laparoscopy. During a laparoscopy, an outpatient surgery also referred to as "belly-button surgery," the surgeon views the inside of the abdomen through a tiny lighted telescope inserted through one or more small incisions in the abdomen. From there, the surgeon may destroy endometrial tissue with heat, laser or by cutting it out. There is a risk of scar tissue, which could lead to infertility, making pain worse, or damaging other pelvic structures. Surgery to remove endometriosis involving the ureters and bowel can be especially complex.

• Laparotomy. A laparotomy is similar to a laparoscopy, but is a more extensive procedure involving a full abdominal incision and a longer recovery period.

• Hysterectomy. During a hysterectomy, your uterus is removed. This leaves you infertile. Hysterectomy alone may not eliminate all endometrial tissue, however, because it can't remove tissue outside of the uterus or ovaries. Additionally, surgery to remove the uterus may not relieve the pain associated with endometriosis.

• Oophorectomy. Removing the ovaries with the uterus improves the likelihood of successful treatment because the ovaries secrete estrogen, which leads to endometrial tissue growth. It also renders you infertile, however.

If you wish to preserve your fertility, discuss other treatment options with your health care professional and consider seeking a second opinion.

There have been no comparative studies of medical and surgical therapies to see which approach is better. Each has advantages and disadvantages. Often, your plan of care will be a combination of treatment options.

3. Alternative treatments.

Alternative treatments for relieving the painful symptoms of endometriosis include traditional Chinese medicine, nutritional approaches, exercise, yoga, homeopathy, acupuncture, allergy management and immune therapy.

While some health care professionals may tell you these alternative paths to seeking pain relief from endometriosis are a waste of time, others may encourage you to try alternative methods of pain relief as long as they are not harmful to your condition. Either way, discuss any options you want to try with your health care professional. Also keep in mind that while these options may help relieve the pain of endometriosis, they won't cure the condition.

4. Pregnancy. While it can't be considered a "treatment" for endometriosis, pregnancy may relieve endometriosis-related pain, an improvement that may continue after the pregnancy ends.

Health care professionals attribute this pregnancy-related relief to the hormonal changes of pregnancy. For example, ovulation and menstruation stops during pregnancy, and it's menstruation that triggers the pain of endometriosis.

Plus, endometrial tissue typically becomes less active during pregnancy, and may not be as painful or large without hormonal stimulation. However, in some cases, once the pregnancy and breastfeeding end and menstruation returns, symptoms may also return.