Treating and Managing Endometriosis
There are different treatments available for endometriosis that aim to reduce the severity of your symptoms and improve your quality of life. The treatments can be medical, surgical or complementary.
Medical treatments can include analgesics (painkillers) and hormonal treatments.
Analgesic treatment may be paracetamol, non-steroidal anti-inflammatories and strong pain relievers. These medications are designed to relieve the pain that can be associated with endometriosis, though they are not intended to reduce the amount of endometriosis present. They may be used as a sole treatment or in combination with other treatments.
Hormonal treatments include the oral contraceptive pill and progestogens (one of the two main female hormones) in a variety of forms. Hormonal treatments can be effective in treating the pain associated with endometriosis, and can be used on their own or in combination with surgical treatment and / or analgesics.
You should discuss the differences in the treatments with your doctor before starting a treatment. There are advantages and disadvantages to all the types of treatments and you may need to have several treatments of different types before finding the right combination for you. Hormonal treatments aren’t suitable for women / wāhine who are trying to become pregnant.
A laparoscopy may be recommended to treat pain and discomfort that hasn’t been successfully controlled with medical therapy, to improve fertility or to remove other areas of endometriosis and preserve fertility as much as possible.
Laparoscopy is a preferred surgical treatments because the risk of scar tissue on the pelvic organs is reduced, the incisions are smaller and less painful during healing and recovery time is faster.
During the laparoscopy the surgeon will be aiming to:
excise (surgically remove) endometriosis and endometrioma
divide adhesions and clear tubes to restore anatomy and improve fertility if that is a desired outcome
A laparotomy involving a larger cut in the abdomen is generally not required.
Hysterectomy (removal of the uterus) should not be considered a cure for endometriosis. It can be helpful for adenomyosis where other treatments options such as Mirena have not been successful.