Endometriosis: Treatment

How endometriosis is treated depends on the woman's symptoms, her age, the extent of the disease, and her personal preferences. The condition cannot be fully eradicated without surgery. Conservative treatment focuses on managing the pain, preserving fertility, and delaying the progress of the condition.

Over-the-counter pain relievers such as aspirin and acetaminophen (Tylenol) are useful for mild cramping and menstrual pain. Prescription-strength and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn), are also effective. If pain is severe, a doctor may prescribe narcotic medications, although these can be addicting and are rarely used.

Hormonal therapies effectively tame endometriosis but also act as contraceptives. A woman who is hoping to become pregnant would take these medications for a period of time, then try to conceive within several months of discontinuing treatment.

• Oral contraceptives. Continuously taking estrogenprogestin pills tricks the body into thinking it is pregnant. This state of pseudopregnancy means reduced pelvic pain and a temporary withering of endometrial implants.
• Danazol (Danocrine) and gestrinone are synthetic male hormones that lower estrogen levels, prevent menstruation, and shrink endometrial tissues. On the downside, they lead to weight gain and menopause-like symptoms, and cause some women to develop masculine characteristics.
• Progestins. Medroxyprogesterone (Depo-Provera) and related drugs may also be used in treating endometriosis. They have been proven effective in minimizing pain and halting the progress of the condition, but are rarely used because of the high rate of side effects.
• Gonadotropin-releasing hormone (GnHR) agonists. These estrogen-inhibiting drugs successfully limit pain and prevent the growth of endometrial implants. They can cause menopause symptoms, however, and doses have to be regulated to prevent bone loss associated with low estrogen levels.

Removing the uterus, ovaries, and fallopian tubes is the only permanent method of eliminating endometriosis. This is an extreme measure that deprives a woman of her ability to bear children and forces her body into menopause. Endometrial implants and ovarian cysts can be removed with laser surgery performed through a laparoscope. For women with minimal endometriosis, this technique is usually successful in reducing pain and slowing the condition's progress. It may also help infertile women increase their chances of becoming pregnant.

— Stephanie Slon