3 Endometriosis Treatment Options

Endometriosis, a chronic and often painful disorder, affects millions of women worldwide. Characterized by the growth of tissue similar to the lining of the uterus outside the uterus itself, endometriosis can lead to a variety of symptoms, including pelvic pain, heavy menstrual bleeding, and even fertility issues. According to the Office on Women’s Health (OWH), at least 6.5 million women have endometriosis in the US alone. Worldwide, the number is estimated to be around 200 million. Luckily, endometriosis treatment options are available. 

Endometriosis Treatment Options

Fortunately, a range of treatment options exists to alleviate these symptoms and improve the quality of life for those affected by this condition. From medication to surgical interventions, Kernodle OB/GYN is here to describe the different approaches to endometriosis treatment options, as each have their own merits and considerations. 

Hormone Therapy

Hormone therapy can help relieve endometriosis symptoms like pain and bleeding. Because these hormonal medications don’t cure endometriosis, they only work for as long as they are taken.

Oral Contraceptives 

Known as birth control or “the pill,” oral contraceptives are often the first endometriosis treatment doctors prescribe. Birth control pills can make periods more regular, shorter, and lighter. Some types of birth control even prevent periods altogether.

• Most birth control pills are combined oral contraceptives. That means that more than one hormone is used in the medication. Usually, the pill is a combination of low doses of estrogen and progesterone. Women who do not tolerate estrogen well are prescribed pills that only contain progesterone.
• Doctors recommend that women with endometriosis take the pill continuously without skipping a week each month. They usually take the pill daily for three to four months and then take a weeklong break for a light period before resuming the medication.

Gonadotropin-Releasing Hormone (GnRH) Agonist And Antagonists

This endometriosis treatment prevents ovulation by stopping the production of certain hormones. When ovulation is stopped, then menstruation is also stopped. This prevents the growth of endometriosis. GnRH medications stop hormones in a way that mimics menopause

• Most doctors recommend staying on GnRH medications for a maximum of six months at a time.
• Symptoms associated with menopause, like hot flashes and sleep disturbances, may occur on this medication
• GnRH medications are available as nasal sprays, pills, and injections.

Progestins

Progestins are hormonal medications that act like progesterone, a female hormone that contributes to ovulation and menstruation. These medications are a good option for women who do not tolerate combined oral contraceptives containing estrogen. 

• Progestins are available in pills that are taken orally each day. They can also be in the form of a long-lasting injection like the Depo-Provera shot. Alternatively,  some women prefer to use an intrauterine device (IUD) like Mirena.

Danazol

Danazol is a synthetic androgen. Androgens are male sex hormones produced in the testes. They are responsible for male reproductive function. Even though they are male sex hormones, the ovaries also produce small amounts of androgens. Danazol treats endometriosis by offsetting estrogen and preventing menstruation.

Pain Medication

Pain medications like over-the-counter NSAIDs such as ibuprofen (Advil & Motrin) and naproxen sodium (Advil) can be taken to relieve pain. They are often recommended to be used along with some form of hormone therapy. If the pain is too severe for those medications to treat in combination with hormone therapy, doctors may consider prescribing a stronger drug.

Surgery

As we’ve said before, endometriosis can’t be cured, but there are surgical procedures that can temporarily relieve the symptoms of endometriosis. Surgery is often recommended when symptoms are severe. Women should talk to their doctors about if surgical endometriosis treatment is right for them, especially if maintaining fertility is a priority.

Laparoscopy

This procedure uses an instrument called a laparoscope, which is inserted into the abdomen through a small incision. The scope has a camera attached to it, so the doctor can see inside of the pelvic cavity. Two or more additional incisions will be made for instruments that can remove or destroy the lesions. The goal of laparoscopy is to remove the harmful tissue without damaging the tissue around it. Women who want to remain fertile often choose this procedure for that reason.

Laparotomy

This surgery is also done to remove endometriosis lesions, but it is an open procedure. That means the surgery is performed by making a large incision in the abdomen to visualize and remove tissue without a scope. During a laparotomy, the doctor may find additional damage caused by endometriosis and remove the uterus and/or ovaries and fallopian tubes. 

Hysterectomy & Salpingo-Oophorectomy

If the uterus, ovaries, and fallopian tubes are all removed, it is called a total hysterectomy and bilateral salpingo-oophorectomy. If any of these procedures are performed, then the woman will no longer be able to get pregnant.

Here at Kernodle OB/GYN, we provide full-scope individualized women’s health care, including gynecological care, midwifery services, and low- and high-risk maternity care for women and their families. If you are struggling with the symptoms of endometriosis and want to discuss endometriosis treatment options, call Kernodle OB/GYN at (336) 538-2367 to make an appointment.