The Treatment of Endometriosis
The treatment of endometriosis is established according to the degree of affectation of the disease, the severity of the symptoms, as well as the woman’s age and state of health. At thes same time, whether the woman wants to get pregnant or not is also taken into account.
When pain’s mild, treatment for endometriosis may consist of over-the-counter medications (such as NSAIDs). However, if the pain is severe, these medications will be insufficient. Therefore, pain can’t be approached in the same way in all cases.
Prescriptions for the treatment of endometriosis
In the treatment of endometriosis, it’s common to combine several medications. Generally, pain relievers and hormone therapy.
If the pain is moderate to severe in intensity, your doctor may order pain relievers to control it. Unlike what occurs in other health problems, such as fibromyalgia, opioid medications could be prescribed in this approach.
Elagolix is the only drug approved by the Food and Drug Administration (FDA) to treat endometriosis pain in women who don’t want to become pregnant.
Since estrogen can aggravate the symptoms of the disease, hormone therapy is aimed at controlling its production in the body. Another beneficial effect of this therapy is that it helps slow the growth of tissue outside the uterus:
- Birth control pills: These contain synthetic estrogen and progesterone, which help regulate menstrual cycles and reduce discomfort. Although they’re a safe option, it’s important to maintain gynecological follow-ups because they can have some side effects.
- Progestin/progesterone (medroxyprogesterone or norethindrone): These options help reduce the impact of symptoms and slow the growth of ectopic endometrial implants.
- Gonadotropin-releasing hormone (GnRH) agonists: This includes the elagolix we mentioned, as it helps suppress the production of gonadotropins, luteinizing hormone (LH), and follicle-stimulating hormone (FSH).
- Danazol: This is a synthetic male hormone or androgen that’s not usually used as a first line of treatment but, rather, when endometriosis doesn’t respond to other forms of approach. It has several serious side effects.
Surgical treatment for endometriosis
When the pain is severe and can’t be controlled with the above options, and there are also fertility problems, surgery is considered. This can consist of a laparoscopy or a laparotomy, experts explain.
Surgery helps remove injuries and sometimes scar tissue as well. This is because the goal is to treat endometriosis and avoid damaging the healthy tissue around it.
Hormone treatment isn’t discontinued with after surgery. In fact, it’s indicative, unless the woman wishes to become pregnant, as the Office for Women’s Health explains well.
Although it has a good prognosis, surgery isn’t a curative treatment. Even when the intervention has been successful, the pain can return at any time.
Over the counter drugs
Some of the over-the-counter medications that may be used successfully to treat endometriosis are non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. These help relieve minor pain.
If the woman doesn’t want to get pregnant, she can turn to NSAIDs. However, if you want to achieve pregnancy (in the near or distant future), other options will need to be considered. In some cases, your doctor might suggest a combination of over-the-counter pain relievers with hormonal treatments, according to the MSD Manual.
Self-care and lifestyle in the treatment of endometriosis
As a complement to all of the above, it’s essential that women try to maintain good life habits. Eating healthy, getting enough daily rest, exercising regularly, and other measures can contribute to significant relief and improvement.
There’s no diet for endometriosis as such. However, women must take into account the fact that a good diet can be beneficial in promoting comprehensive well-being and preventing complications.
According to Dr. Miriam Al Adib Mendiri, adopting and maintaining a diet that helps balance estrogens (and thus avoid hyperestrogenism) and decrease inflammation can be beneficial. Some guidelines to keep in mind would be the following:
- Include sources of omega 3 fatty acids regularly in the diet.
- Maintain a regular consumption of fruits and vegetables.
- Get enough fiber on a daily basis.
- Take probiotics and prebiotics regularly.
- Moderate the consumption of red meat.
- Prioritize the consumption of whole-grain cereals over refined ones.
Likewise, you can consult with the specialist about the consumption of multivitamin supplements. It’s not a good idea to take them without the approval of a specialist.
Experts at The Center for Young Women’s Health (CYWH) indicate that exercise doesn’t aggravate endometriosis symptoms and that it can be very helpful in controlling them. Therefore, they recommend doing about 60 minutes a day.
- Walking, dancing, swimming, and yoga (with or without a Swiss ball or exercise ball) are some options.
- High-intensity exercise isn’t recommended as it can promote discomfort.
- The practice of sports can be combined with physical therapy sessions to achieve greater relief.
Sitz baths and others
Warm sitz baths and hot compresses can also help relieve pain and can be done several times a day. Before adding any type of natural ingredient, it’s best to consult with your doctor.
Hot compresses should always be used with gauze or a fine cloth over the area. This keeps you from burning the skin.
Even when the evidence is limited and its effectiveness hasn’t been demonstrated, acupuncture can be considered as an adjunct to relieve pain.
Finally, it’s important to keep in mind that adherence to treatment is what will guarantee part of your success. For this reason, always maintaining good communication with the specialist is essential, not only when solving specific concerns.