Affecting as many as 10 to 15% of women worldwide, endometriosis is a condition that can have a significant impact on daily life. It happens when tissue from the lining of the womb begins to grow elsewhere while still being affected by the hormonal changes of the menstrual cycle. This means the tissue breaks down and bleeds, which can cause pain, scarring and inflammation in the affected areas.
Endometriosis affects women in all stages of life, including teenagers. Although there isn’t a cure for this yet, scientists and researchers are working towards developing one, but you may ask what can you do to treat the condition in the meantime?
What options are there for treating endometriosis?
If you’ve been diagnosed with endometriosis, your doctor will be able to give you an in depth explanation of the treatment options available to you. They’ll also be able to discuss the benefits and drawbacks of each option and relate it back to your personal situation. Your circumstances and medical history may mean that certain options are better suited to you than others. Factors that might affect which treatment is best for you include:
- Your age
- How your symptoms present themselves
- Whether or not you want to have children in the future - as some treatments may reduce the likelihood or prevent you from conceiving
- Whether or not you’ve already tried any of the treatment options
- Your preferences on having surgery
Rather than focusing on the fact there is yet to be a cure for endometriosis, it’s important to acknowledge that there are treatments that focus on reducing the impact symptoms have on your daily life in order to make it easier for you to perform your usual activities.
If your symptoms are mild, you may not need treatment at all and you can monitor your condition until you do need treatment - if you ever do. It might also be beneficial to wait and monitor your symptoms if you’re approaching the menopause. This is because endometriosis symptoms sometimes ease once you’ve gone through the menopause due to the drop in oestrogen levels.
If you decide to pursue treatment for your endometriosis, it’s likely you’ll be given three options. These are:
- Hormone therapy
- Pain relief
Which HRT is best for endometriosis?
Hormone replacement treatments for endometriosis are intended to limit the production of oestrogen in your body. This is because oestrogen encourages the growth and subsequent shedding of endometrial tissue - the tissue that makes up the lining of your womb. Lowering oestrogen levels can help to reduce pain from endometriosis as well as limiting the amount of endometrial tissue that grows outside of the womb.
Some examples of hormone treatments used in endometriosis cases include:
- The combined contraceptive pill
- The progestogen-only pill
- The intrauterine system
- The contraceptive implant
- The contraceptive injection
- Gonadotropin-releasing hormone analogues
Although not all of the above treatments are licensed as contraceptives, they have the effect of temporarily reducing your fertility. Also, it’s important to be aware that if you choose a hormone treatment which isn’t licensed as a contraceptive, you will also need to use a form of contraception if you don’t wish to get pregnant.
What is endometriosis surgery?
If you’re comfortable with undergoing surgery to treat your condition, doctors can physically remove or destroy sections of endometrial tissue growing outside of the womb. This can reduce some of the symptoms of endometriosis but, like any operation, it comes with risks that your doctor should discuss with you in detail.
Surgery usually involves a laparoscopy - also known as keyhole surgery - where your surgeon will make a small incision and remove tissue using very small tools and a camera on a tube. This type of surgery minimises scarring and healing times and can help to improve your fertility.
If keyhole surgery and other treatments haven’t worked, and you don’t want to get pregnant, a surgeon can perform a hysterectomy. This is the removal of the uterus, and sometimes the ovaries and cervix are removed at the same time. Symptoms can still return after a hysterectomy, although it’s rare. It’s also worth remembering that removing the uterus means you won’t be able to get pregnant in the future. Hysterectomies are much more intense than laparoscopies, and they aren’t reversible, so it’s important to be sure before you agree to have the surgery.
What helps endometriosis pain?
If you don’t want to use hormone treatments or have surgery, the painful symptoms of endometriosis may be managed with over the counter painkillers such as ibuprofen and paracetamol. These are anti-inflammatory medicines, so they may help to reduce pain and swelling in the areas affected by endometrial growth.
Additionally, you may be able to ease pain and discomfort with non-medicinal pain relief such as warm compresses. Physiotherapy may help to ease pain and discomfort as well. If you’ve been using painkillers and soothing techniques such as these for several months without improvement, you should speak to your doctor about alternative treatment options.
How to get pregnant with endometriosis
Although it can be harder to get pregnant if you have endometriosis, it is by no means impossible. Many women with endometriosis can get pregnant naturally without any intervention - but it may be quicker and easier to use fertility treatments to boost your chances of conception. In fact, it’s recommended that women with endometriosis speak to a fertility specialist sooner rather than later in order to have the best possible chances of conceiving a healthy baby.
How to get diagnosed with endometriosis
Getting a diagnosis for endometriosis can be difficult. This is because the symptoms vary considerably from person to person, overlap with other conditions and can be misdiagnosed. With this in mind, it helps if you can give doctors as much information as possible to base their conclusions on. Things that may help include:
- Keeping a detailed record of your symptoms - including what you experienced, when it happened and any potential triggers
- Being transparent about your medical history and lifestyle
- Asking your partner or a close friend or family member to come with you for moral support
- Speaking to those who already have a diagnosis
If you suspect you have endometriosis, it’s important to be examined by a doctor as soon as you can. Even if your symptoms turn out to be the result of something else, the most important thing is to find out what's causing you pain and get treatment for it. Endometriosis is a chronic condition, but it can be treated. With fertility treatments available around the world, around 70% of women with endometriosis can get pregnant so it’s entirely possible to have a baby after an endometriosis diagnosis.