How Is Endometriosis Treated?

As described in our blog post on how doctors diagnose endometriosis, the condition involves endometrial tissue that grows outside the uterus where it’s normally found. Despite the abnormal location, the tissue continues functioning as it would within the uterus following a typical menstrual cycle. 

Problems arise because blood from tissue growing outside the uterus can’t exit the body properly.   

 

Endometriosis Symptoms and Diagnosis

Endometriosis symptoms, include pelvic pain that increases with time and extends longer into a woman’s period, excessive bleeding, bleeding between periods, pain during or after sex, and painful urination or bowel movements. Women may also experience infertility, fatigue, bloating, nausea, constipation, and diarrhea.

 

It’s important to note that the amount of pain experienced and the severity of endometriosis don’t necessarily align. A mild case can cause more pain than a more advanced one.   

 

Doctors can use several different exams in diagnosing endometriosis, including:

• Manual pelvic exam
• Ultrasound or magnetic resonance imaging (MRI) scans
• Laparoscopy, in which a device with a camera is inserted into a tiny slit in the abdomen, the vagina, or both

Doctors assign stages 1 through 4 to endometriosis based on how far from the uterus the tissue is and how much of it is there. Stage 4 is the most advanced. 

 

Treating Endometriosis

There are both non-surgical and surgical methods for treating endometriosis. 

Non-surgical endometriosis treatments

Doctors most commonly address endometriosis without surgery. Treatment can include pain medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, at prescription strength if needed. 

 

Doctors can also prescribe hormones as pills, injections, or nasal sprays. This includes: 

 

• Oral contraceptives with estrogen and progesterone that control hormones
• Progestins that stop menstrual periods and endometrial tissue growth
• Gonadotropin-releasing hormone antagonists that reduce hormones in the ovaries
• Gonadotropin-releasing hormone agonists that stop ovarian hormone production

Surgical endometriosis treatments

Patients who are trying to conceive and consequently can’t use hormone treatments or who have advanced endometriosis may need surgery. The three methods used are:

• Laparoscopy. In this procedure, the surgeon makes a few small incisions in the abdomen through which they insert a tiny camera and various tools to remove or destroy endometrial tissue. Doctors also use this approach to remove scar tissue in affected areas. Laparoscopic surgery requires less recovery time and leaves only small scars. 
• Laparotomy. This less-common procedure involves a larger incision through which the surgeon removes endometrial tissue. Both laparotomies and laparoscopies relieve pain, but endometrial tissue can return and cause pain. 
• Hysterectomy and oophorectomy. In these procedures, the surgeon removes the uterus, ovaries, or both. They provide a permanent solution to endometriosis but prevent future pregnancies (if the uterus is removed) and cause the patient to enter menopause. If only the ovaries are removed, the patient may be able to become pregnant through in vitro fertilization (IVF). 

Post-Treatment Prognosis for Endometriosis

Endometriosis treatment can provide pain relief. However, the condition may return unless the uterus and ovaries are removed. Consequently, patients who have been treated for endometriosis should see their doctor regularly and be vigilant for new symptoms. 

 

Learn About Endometriosis Treatment from Baptist Health

Doctors can treat endometriosis successfully through medication or surgery. If you have pain or other endometriosis symptoms, talk with your physician. They can diagnose your condition and may refer you to our women’s health services experts.