What Are Endometriosis Treatments And How To Manage The Symptoms?

A substantial number of women suffer from endometriosis symptoms, such as dysmenorrhea (severe menstruation cramps and pain) and infertility. Not to be mistaken with Polycystic ovary syndrome (PCOS) which is a hormonal disorder, endometriosis occurs when the endometrium, the tissue which normally borders the uterus, develops outside it.

During menstruation, this tissue will break down and bleed like normal uterine tissue. But this blood would remain stuck. Neighbouring tissues could become swollen or inflamed and may lead to the formation of lesions and scar tissues.

What Treatments Are Available For Endometriosis?

Endometriosis can bring about various challenges in a person’s daily life if it is not properly treated. Although there is no cure for endometriosis, its symptoms can still be treated and managed.

There are treatment options, in the form of medications and surgery to assist in controlling the symptoms as well as any potential complications that might arise. Your doctor may start with mild, conservative treatments and may subsequently recommend surgery if the condition shows no improvement with the initial treatments.

1. Pain Medications

If the symptoms you are experiencing are mild, your doctor may prescribe a pain reliever. These medications may include NSAIDs (non-steroidal anti-inflammatory drugs) like naproxen or ibuprofen.

The pain caused by endometriosis can be more intense in certain cases. If the pain medication does not provide adequate relief, your doctor may consider prescribing you stronger medications to help manage the pain.

2. Hormone Therapy

Hormone therapy can help ease the pain and discomfort caused by endometriosis. Hormonal fluctuations cause implants of the endometrium to thicken, disintegrate, and bleed. Hormone therapy may reduce endometrial tissue development and prevent new endometrial implants.

However, this treatment is not a permanent cure for endometriosis. Symptoms may reappear if you stop the treatment.

Examples of hormone therapies used in treating endometriosis include:

• Hormonal Contraceptives 

Hormones that cause endometrial tissue accumulation each month can be controlled by contraceptives such as birth control tablets. Hormonal contraceptives cause menstrual flows to be shorter and lighter. Hormonal contraceptives may help lessen or eliminate the pain caused by endometriosis in certain cases.

• Gnrh Agonists and Antagonists

These medications suppress ovarian function, reduce oestrogen levels and in doing so, prevents menstruation. This in turn would cause the endometrial tissue to shrink. However, once you stop taking the medication, menstrual periods and fertility would resume as normal.

• Progestin Therapy

Endometriosis symptoms can be relieved by a range of progestin treatments, such as the use of an intrauterine device with levonorgestrel, contraceptive implants, contraceptive injections, or progestin tablets.

• Aromatase Inhibitors

Aromatase inhibitors are a group of drugs that lower oestrogen levels in the body. To treat endometriosis, your doctor may prescribe an aromatase inhibitor alongside a progestin or a hormonal contraceptive.

3. Conservative surgery

If you suffer from endometriosis and plan on getting pregnant, having the endometriosis implants removed while keeping your uterus and ovaries may help. 

This endometriosis surgery may also help relieve severe endometriosis pain. However, the pain may recur after the surgery.

This procedure may be performed laparoscopically, or in more severe circumstances, via standard abdominal surgery. Laparoscopic surgery involves inserting a piece of thin viewing equipment (laparoscope) along with instruments to have endometrial tissue removed through tiny incisions around the navel.

Your doctor may prescribe hormone therapy to help reduce the pain post-surgery. 

3. Hysterectomy and Oophorectomy

If your reproductive organs are injured or endometriosis tissues are present on them, your doctor may need to remove them entirely or just the parts that have been affected. A hysterectomy refers to the removal of the uterus, while an oophorectomy refers to the removal of the ovaries.

Doctors may suggest a hysterectomy for women who experience persistent symptoms despite alternative therapies and do not plan on having children.

A hysterectomy can be performed through laparoscopy, laparotomy, or by removing the organs through the vaginal opening.

Ways to reduce pain during menstruation

Menstrual pain or menstruation for those with endometriosis is usually more serious than for women who do not have it. The pain experienced can affect a person's life to the point of making daily activities difficult such as not being able to go to school or work.

Here are some things that can be done to reduce the pain of menstrual cramps experienced

• Use a hot pad or hot towel

• Electrical nerve stimulation (TENS) can also help

• Massage on the pelvis

• Warm water bath

• Drink hot ginger tea

• Soothe yourself by putting a fragrant scent like lavender in the room

For more information, please contact your doctor or pharmacist.

The information provided is for information purposes only and is not meant to be a substitute for the advice of a registered medical practitioner. This information should not be used for diagnosing health problems or for self-medication. Bayer Co (Malaysia) Sdn Bhd shall not be responsible for any damages or losses arising out of access to or use of information provided.

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This educational article was brought to you in collaboration with Bayer.

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