Surgical treatment often improves pain symptoms associated with endometriosis, and is offered in addition to hormonal treatments. Surgery may assist in diagnosis of endometriosis, especially for minimal or mild endometriosis where ultrasound scans may be normal.
These medications induced a ‘menopause-like’ state, and a low-dose hormone replacement may be given at the same time to manage side-effects and long-term effects. Some medications aim to ‘turn-off’ the body’s natural hormone production to reduce the activity and growth of endometriosis.
Some women will experience side effects with hormonal treatments. Hormonal treatments are available in multiple types, including tablets (such as the combined oral contraceptive pill – ‘the pill’), intrauterine devices (the Mirena), implants or injections. Hormone treatments are used to suppress the normal menstrual cycle, which in turn stops or slows endometriosis growth and in some women are effective in reducing endometriosis-related pain. Many women will experience some relief of symptoms with over-the-counter medications such as paracetamol (Panadol) and non-steroidal anti-inflammatories (Ponstan, Nurofen, Naprogesic, etc). When pain is the main problem, the treatment aims to relieve symptoms and lessen the pain. Medication for endometriosis has not been shown to improve fertility. Other causes of infertility should be looked for and treated. If a hydrosalpinx is found, it is often recommended that the affected tube or tubes are removed at the time of surgery. However, there is also a reduction in success rates with assisted reproductive technologies such as IVF if there is a hydrosalpinx present. Treating more severe endometriosis with surgery, especially if there are cysts in the ovaries, might also improve fertility, but this hasn't been proven. If the fallopian tubes are blocked and fluid-filled (hydrosalpinx), natural fertility is reduced. Surgery has been shown to improve fertility for women with mild endometriosis. Small endometriomas that are not causing symptoms may be observed with regular ultrasounds. They may be removed surgically if they are causing symptoms or they are large. The most common surgery approach is laparoscopy (key-hole surgery).Ĭysts of endometriosis on the ovaries (endometriomas), are unlikely to disappear on their own and generally cannot be treated with medicine. Surgery can be used to remove or destroy the endometriosis. Medications range from pain relief drugs (such as paracetamol and anti-inflammatories), to hormonal treatments that suppress ovulation and periods. Benefits and disadvantages of different treatments.Alternative and complementary therapies.Some women also benefit from alternative therapies. Sometimes both medicine and surgery are used. Endometriosis can be treated medically (with drugs or medicine) or with surgery.
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