While endometriosis currently has no definitive cure, there are many effective treatment options available that can significantly alleviate pain and manage symptoms, helping those affected to lead a more comfortable and fulfilling life.
Medical treatment for endometriosis largely depends on the severity of each patient’s symptoms, their age, and if they are hoping to become pregnant. In this article, we discuss the most common medication for endometriosis, as well as some natural alternatives for those seeking to avoid any side effects.
What Is Endometriosis?
Endometriosis is considered a chronic condition that affects approximately 10% of women during their reproductive years. It occurs when endometrial-like tissue, grows outside of the uterus. This endometrial-like tissue can form cysts, lesions, and adhesions on pelvic organs like the ovaries, fallopian tubes, bladder, bowel, and rectum.
Medication for Endometriosis: The Most Used
As of yet, there is no cure for endometriosis, but treatment and medication can ease the symptoms. Medication for endometriosis can typically differ from patient to patient based on their symptoms, age, and whether or not they are hoping to get pregnant.
The most common types of medication for endometriosis when women are not trying to conceive are pain relievers and hormone therapy. Which type of pain relief and hormone therapy will depend on the severity of each patient’s symptoms.
Pain Medication & Anti-inflammatories
For patients experiencing mild pelvic pain with endometriosis, over-the-counter pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or aspirin are often one of the first types of medication recommended. If the pain is more severe and does not respond to over-the-counter pain relievers, healthcare providers will usually prescribe something stronger.
If you are not hoping to become pregnant, healthcare providers might also recommend taking hormonal contraceptives in conjunction with pain relievers to ease the symptoms of endometriosis.
Because endometrial-like tissue growing outside of the uterus reacts to hormone fluctuations during the menstrual cycle, hormone therapy is often prescribed to lower estrogen levels and ease the symptoms of endometriosis.
A surge in estrogen (during the mid-follicular stage and mid-luteal stage) causes endometrial cysts, lesions, or adhesions to swell and eventually bleed during menstruation. This can result in any or all of the above-mentioned symptoms depending on the amount, depth, and location of endometrial-like tissue growth outside of the womb.
Hormone therapy can help alleviate symptoms of endometriosis by reducing or stopping hormone production, thereby slowing the growth of misplaced endometrial tissue and preventing new tissue from growing.
The following are the most common hormone therapies prescribed to treat endometriosis.
Hormonal contraceptives are prescribed to women with mild to moderate endometriosis to alleviate symptoms linked to menstruation. Known to shorten and lighten the flow of periods, or stop them completely, hormonal contraceptives can relieve the pelvic pain, cramping, and heavy menstrual flow associated with endometriosis.
The different forms of hormonal contraceptives include:
Estrogen & Progestin
Used to prevent ovulation. Depending on their symptoms, some endometriosis patients are advised to take the pill every day. Others will only take it for 21 days to allow for menstruation, which is typically lighter and causes less or no pain. You can learn more about the function of progesterone for endometriosis here.
Used to prevent ovulation if endometriosis patients cannot take estrogen, suffer from cardiovascular conditions, or pose a higher risk of blood clots. This type of hormonal contraceptive is taken every day and it only works if taken at the same time each day.
Intrauterine Device (IUD)
A progestin IUD, which is inserted into the uterus, is typically used to lighten menstruation and shrink painful endometriosis lesions growing outside of the womb.
Gonadotropin-releasing hormone (Gn-RH) Agonists and Antagonists
GN-RH agonists and antagonists are another form of hormone therapy, but not considered a hormonal contraceptive. This type of medication is used to treat severe endometriosis, or when patients find little to no relief from pain relievers and hormonal contraception. They are also frequently used after endometriosis surgery to prevent the re-growth of misplaced endometrial tissue.
Taking Gn-RH agonists and antagonists eases the symptoms of endometriosis by stopping the ovaries from producing estrogen and shrinking endometrial-like tissue growing outside of the uterus. This type of medication also instigates artificial or temporary menopause. It is therefore not recommended if women with endometriosis are trying to get pregnant.
Symptoms of artificial menopause can include hot flashes, mood swings, insomnia, and vaginal dryness. To relieve these symptoms, patients are typically prescribed a low dose of estrogen and progestin in conjunction with Gn-RH agonists and antagonists. However, because low estrogen levels can contribute to the loss of bone density, GN-RH antagonists are usually prescribed for no longer than 24 months.
Although it was the most popular medication for endometriosis a few decades ago, the use of Danazol has declined since GN-RH agonists and antagonists were introduced in the 1980s. While it can relieve symptoms of endometriosis by reducing estrogen levels, danazol is a synthetic androgen, which is a hormone predominantly found in males.
Even though small amounts of androgens are also produced by the ovaries, the side effects of taking Danazol outweigh the benefits for many endometriosis patients. These include facial hair growth, weight gain, deep voice, excess body hair, enlarged clitoris, and high cholesterol.
Women taking Danazol to treat endometriosis are also advised to use contraception to prevent pregnancy. Because Danazol is a synthetic androgen, it can cause a female fetus to develop male characteristics.
When women with endometriosis are hoping to get pregnant, healthcare providers may recommend speaking with a reproductive endocrinologist about fertility treatment. This type of medication helps the ovaries to produce more eggs.
Are There Risks with Hormone Therapy?
Although hormone therapy is commonly prescribed to ease the symptoms of endometriosis, risks and side effects can include infertility, hot flashes, breast tenderness, vaginal dryness, loss of bone density, headaches, joint pain, stiffness, insomnia, depression, and heart complications.
The easing effects of hormone therapy on endometriosis symptoms will also only last as long as patients are taking it. As soon as patients stop, endometriosis symptoms typically return.
Alternatives to Hormone Therapy for Endometriosis
Even though hormone therapy can help to alleviate symptoms of endometriosis, the side effects and the inability to get pregnant are off-putting for many women.
To avoid the side effects of hormone therapy, and increase their chances of getting pregnant without fertility medication, the following treatment options are recommended by holistic female health experts and they include physical therapy, acupuncture, pelvic wand or vaginal dilator therapy for endometriosis. Some treatment regimens may involve more than one as part of a routine.
If you decide to try pelvic wands and/or vaginal dilators to treat endometriosis, consider scheduling an appointment with a pelvic health specialist who can show you how to use each correctly for the best results.
The most common forms of medication used to ease symptoms of endometriosis include pain medication and various forms of hormone therapy. The type of hormone therapy prescribed depends on the stage of endometriosis, the severity of symptoms, and if patients are hoping to get pregnant.
Due to the side effects of hormone therapy, alternative treatment options for endometriosis often include physical therapy and the use of pelvic wands & vaginal dilators to relieve pelvic discomfort and pain during sex.
Women’s Health – Endometriosis - https://www.womenshealth.gov/a-z-topics/endometriosis
Cleveland Clinic – Menstrual Cycle - https://my.clevelandclinic.org/health/articles/10132-menstrual-cycle
National Library of Medicine - Effects of nonsteroidal anti-inflammatory drugs at the molecular level - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039135/
Medline Plus - Estrogen and progestin - oral contraceptives - https://medlineplus.gov/druginfo/meds/a601050.html
Cleveland Clinic - Estrogen - https://my.clevelandclinic.org/health/body/22353-estrogen
Medline Plus - Progestin-Only Oral Contraceptives - https://medlineplus.gov/druginfo/meds/a602008.html
Endometriosis Foundation - Everything You Need to Know About Pelvic Floor Physical Therapy (PFPT) for Endometriosis - https://www.endofound.org/everything-you-need-to-know-about-pelvic-floor-physical-therapy-pfpt-for-endometriosis
National Centre for Complementary & Integrative Health – Acupuncture: What You Need to Know - https://www.nccih.nih.gov/health/acupuncture-what-you-need-to-know
Pelvic Pain Doc - Mashable: Intimate Rose Products Relieve Pelvic Pain - https://www.pelvicpaindoc.com/blog/mashable-intimate-rose-products-relieve-pelvic-pain/