What are the treatment options for endometriosis?

Doctors treat endometriosis by locating the growth of the tissue and removing it.

If medical management is not enough to treat endometriosis, your doctor may recommend surgery. Robot-assisted surgery is used to treat endometriosis.

In the treatment of endometriosis, surveillance is always important. Once you've begun medical therapy for endometriosis, there should be surveillance of how you are doing, that your symptoms continue to be controlled and that your priorities are being met. If it's pain control, and as time goes by the severity of the pain is not worsening, then the current medical modality that you're using is continuing to work. At the point that it is no longer effective, then there can always be a change in the medication therapy. For instance, if you start with the birth control pill and that's no longer controlling your pain, you can try a continuous birth control pill.

If medication is not working, then your doctor may consider a diagnostic evaluation for endometriosis. In that same process, areas of endometriosis that are found can be surgically removed.

Treating endometriosis surgically can improve the ability to conceive. So for women who are seeking pregnancy, have known infertility or are seeking pregnancy and are having pain that's either no longer managed by medication, or are seeking fertility and therefore cannot use hormonal medications (that also act as contraceptives), it's an important time to move forward with surgery.

The efficacy of controlling pain from endometriosis with medication and with laparoscopy or surgical technique is equivalent in many studies. It's appropriate to continue on medical therapies as long as symptoms are controlled until you either desire fertility or pain is no longer controlled.

Endometriosis treatment starts with surgery and a biopsy to definitively diagnose the condition.

Endometriosis is uterine tissue that lies outside the uterus, which grows and degrades with the menstrual cycle just like the normal uterine lining. Ovarian hormones, such as those found in birth control pills, interrupt this cycle and prevent the tissues from swelling and bleeding. This will often greatly reduce the pain of endometriosis.

Endometriosis may be treated with medications such as nonsteroidal anti-inflammatory drugs to relieve the pain. Also, there are several hormonal treatment options, some of which have the added benefit of contraception, if so desired.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Despite the painful symptoms and difficult diagnosis associated with endometriosis, the bottom line is that it is a very treatable condition—something no woman should have to suffer through. Treatment varies depending on the severity of symptoms and what stage of life you are in (i.e., if you still wish to have children). Some options include hormonal therapy, pain treatment, nutritional therapy and even surgery. Since the best line of treatment varies drastically from patient to patient, my best advice is to have an open conversation with your doctor. Do a little research ahead of time to familiarize yourself with all the treatment options and spend some time thinking about what you prioritize in a treatment (i.e., whether you would prefer to improve fertility, take a more natural approach, take a more permanent solution, etc.).

Depending on a woman's age and the severity of the condition, treatment options for endometriosis may include medication, surgery or both. Endometriosis cannot be cured, but it can be managed. 

Pain medications, like over-the-counter pain relievers or stronger prescription medications like opioids, are sometimes used to manage mild pain. Hormone therapy may help slow the growth of endometrial tissue and prevent new lesions from growing. Birth control, progesterone, gonadotropin-releasing hormone (GnRH) agonists and intrauterine devices can be used as part of a long-term care plan, but many are not specifically indicated for the treatment of endometriosis.

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Over-the-counter pain relievers, such as ibuprofen, can often help relieve endometriosis pain. But, if you are still experiencing painful symptoms your doctor may want to try more serious treatments. These treatments include different hormone therapies to deter menstrual swelling. Your doctor may simply take out the endometrial tissue or perform a hysterectomy, in which the uterus is removed entirely.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.