How is endometriosis treated?
There are two main forms of treatment available: surgery and drug therapy. The most appropriate method will be chosen according to the severity and location of the endometriosis.
Surgery can be performed to remove areas of endometriosis, and parts of the reproductive organs if they are badly affected. Decisions about the extent of the surgery, however, will depend on whether a woman wishes to conceive in the future. Surgery may also help if the endometriosis is causing fertility problems.
The most common form of treatment is drug therapy. There are a number of drugs that can be prescribed according to each woman’s particular circumstances. If one drug is not well tolerated, another can be prescribed. A group of drugs called GnRH analogs may be used to treat endometriosis. These drugs work by decreasing the activity of the ovaries, leading to inhibition of endometrial growth. Drugs in this group include goserelin (Zoladex), leuprolide (Lupron Depot), and nafarelin (Synarel). GnRH analogues can cause side effects similar to the symptoms experienced during the menopause. They are often prescribed to reduce the number and size of endometrial lesions and may also be given to thin the endometrium prior to surgery. It is important that pregnancy does not occur during treatment; therefore, women must use a barrier method of contraception during treatment. Progestogens such as medroxyprogesterone (Provera) and norethindrone (Aygestin) suppress ovulation, but normal ovulatory cycles can return two months after treatment is stopped. They are therefore useful for women who wish to conceive after treatment. The combined oral contraceptive pill may also help in decreasing the severity of endometriosis. Pain medication such as ibuprofen (Advil, Motrin) or naproxen (Aleve) may also be used.
Endometriosis Association: www.endometriosisassn.org
Pubmed Health: www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001913/
Last reviewed: May 2013