Coping With the Pain of Endometriosis

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Pain is the most common symptom of endometriosis. The pain comes from endometrial tissue growing on the organs and other structures in the pelvis. The growths can irritate the entire pelvic region, leading to widespread pain. Women may have pelvic pain or very painful menstrual cramps. Some have lower back pain. No matter what type pain you have, there are ways to manage the pain and stay comfortable.

Medications

Your doctor may recommend medication to control your pain from endometriosis. Pain relievers and hormone-based treatments are two main types of medications to treat endometriosis pain. Sometimes, over-the-counter drugs like ibuprofen or naproxen are enough. Other times a prescription pain drug is necessary.

Hormone treatment works by lowering the level of estrogen in your body, or reducing its effects. This, in turn, decreases the growth of endometrial tissue. Doctors often prescribe hormonal birth control pills for endometriosis pain. There are many types of birth control pills available. The different types of birth control pills seem to work equally well for endometriosis pain.

Synthetic hormones called progestins can also manage pelvic pain from endometriosis. They can cause some side effects. These could include weight gain, depression, abnormal bleeding, and headaches. They may also cause infertility for a few months after stopping them.

You can stop menstruation with medications called gonadotropin-releasing hormone (GnRH) agonists. They work well to control pain, but they do have side effects. These can include weakened bones, hot flashes, and vaginal dryness. Women usually take these medications for only about six months.

Surgery

Sometimes endometriosis is so severe that pain treatments don’t work well. Relieving the pain may require surgery. The surgery removes the endometrial growths that cause the pain. Usually surgery is an option only for the most severe cases of endometriosis, when pain keeps you from daily activities.

Some types of surgery allow a woman to still get pregnant. However, the pain may return later on. A hysterectomy involves removing the uterus and sometimes the ovaries. A hysterectomy means you can no longer become pregnant. But, it may be more helpful in managing the pain.

Lifestyle Changes

Many women find that getting regular exercise helps them manage their endometriosis pain. Heat therapy can also help. Soaking in a hot bathtub or putting a heating pad on an aching pelvis can soothe pain. The heat allows the muscles to relax. If you have pain during sex, try different positions that may be more comfortable for you. These tips can help you soothe pain temporarily, but you will probably still need medical treatment for better pain relief.

Talk with your doctor about the best ways for you to bring your pain from endometriosis under control. Be an active participant in your care by exploring all your options. When you discuss with your doctor the benefits and risks of each option, you’ll be better able to make a choice that is right for your level of endometriosis pain.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Nov 27

  1. Endometriosis. American Society for Reproductive Medicine. https://www.asrm.org/BOOKLET_Endometriosis/ 

  2. What Is Endometriosis? Endometriosis Foundation of America. http://www.endofound.org/endometriosis

  3. Endometriosis. PubMed Health, National Library of Medicine, National Institutes of Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072685/

  4. Endometriosis: Lifestyle and Home Remedies. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/endometriosis/basics/lifestyle-home-remedies/con-20013...

  5. Endometriosis. Womenshealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/endometriosis.html

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