Endometriosis: What Are Your Treatment Options?

This article is for women with endometriosis, or their care partners, or anyone who wants to learn more about endometriosis. The goal of this patient education activity is to educate patients on the importance of engaging with their doctor and healthcare team about treatments for endometriosis.

You will learn about:

• How endometriosis is treated

• How different medicines for treating endometriosis work and what side effects they might have

• Surgery to treat endometriosis

• Making a treatment plan with your doctor

• Questions to ask your doctor

Endometriosis happens when tissue that normally lines the inside of your uterus (the endometrium) grows outside your uterus, where it doesn't belong.

This tissue still acts like it should during your menstrual cycle and will thicken, break apart, and bleed. Because the tissue and blood can't leave your body like it does during your period, the surrounding areas become irritated and swollen, and scar tissue can form.

This can cause pain and other problems, such as:

• Blocked fallopian tubes and infertility (not being able to get pregnant)

• Blood trapped in your ovaries that can form cysts

• Intestine and bladder problems

There is no cure for endometriosis, but the good news is there are treatments to help with the symptoms and problems it causes.

The goals of treatment are to control pain and prevent endometriosis from getting worse. This can involve medicine and, for some women, surgery. Which treatment you and your doctor choose will depend on how bad your symptoms are and whether or not you want to get pregnant someday.

If your pain isn't too severe, pain relievers you can get without a prescription may be enough. Your doctor may recommend ibuprofen (Advil^® or Motrin^®) or naproxen (Aleve^®).

If these don't provide enough relief, your doctor may suggest another treatment, like prescription medicines or surgery.

These can include:

• Hormonal contraceptives -- such as birth control pills, patches, and vaginal rings -- to help control the hormones that cause endometrial tissue buildup during your menstrual cycle

• Progestin therapy -- such as an intrauterine device (IUD), injections, implant, or pills -- to stop your periods and slow or stop endometriosis growth

• Gonadotropin-releasing hormone (GnRH) agonists and antagonists to block certain hormones and slow or stop endometriosis growth

Other medicines your doctor may prescribe can include aromatase inhibitors (AIs) to decrease the amount of estrogen in your body.

Medicines affect everyone differently, but it usually takes about 2 to 3 months to see symptoms get better and for your body to get used to a new medicine.

Different medicines can have different side effects, but most go away after treatment is stopped and your menstrual cycle returns.

Side effects you may experience with hormonal contraceptives or progestin therapy can include:

• Irregular bleeding or spotting

• Breast tenderness

• Nausea

• Weight gain or bloating

• Headaches

• Mood swings, including depression

• Body hair and/or hair thinning

With GnRH agonists and antagonists, you may experience:

• Hot flashes and night sweats

• Vaginal dryness

• Mood swings, including depression

• Headaches

• Hair loss

• Heart problems

Progestin therapy, GnRH agonists and antagonists, and AIs may also cause bone loss over time.

Be sure discuss side effects -- including any you experience -- with your doctor or pharmacist.

Your doctor may discuss surgery as a treatment option. Surgery typically removes growths outside of your uterus, which can cut down on pain. However, growths and pain can sometimes come back, so you may need to also take medicine.

In more severe cases, your doctor may recommend a hysterectomy. This is surgery where the uterus -- and sometimes the cervix and/or ovaries -- is removed.

Surgery, as with any treatment, may have certain risks, so be sure to discuss all your options with your doctor before treatment to find the best one for you.

Several treatments can help manage symptoms and may help improve your chances of getting pregnant.

If you're not trying to get pregnant right away, medicine may be a good option. Once you stop the medicine and your menstrual cycle returns, you may have a better chance of getting pregnant.

If you're trying to get pregnant and haven't been able to, surgery to remove endometrial growths while keeping your uterus and ovaries may increase your chances of success. It's important to remember that if you have surgery that removes your uterus (hysterectomy) and/or ovaries, you will be unable to get pregnant after that.

You and your doctor can create a plan that includes which treatment is right for you and when to start or stop treatment. Not every medicine will work for everyone so it might take some time to find the best treatment for you.

Record your symptoms in a journal or diary. Don't leave out symptoms, even if they don't seem related to endometriosis. Be sure to record when your pain happens and describe it clearly, using words like dull, sharp, deep, or burning.

Don't hesitate to speak up about your pain. Describe how pain affects your life. Is it bad enough to make you skip social events or miss school or work? Does it vary from month to month?

Questions to ask your doctor can include:

• What treatments are available and what are their side effects?

• When should I begin treatment?

• How long will it take for treatment to start working?

• For how long will I need to take treatment?

• Will this affect my chances of getting pregnant?

• Will I need surgery?

• Will my endometriosis get better or go away when I go through menopause?

• Are there lifestyle changes I should make?

Congratulations!

You have successfully completed the program: Endometriosis: What Are Your Treatment Options?

View Additional Materials

View Additional Materials on this topic that you may find useful

Endometriosis Association Website

Could Your Pain Mean You Have Endometriosis?