Endometriosis is a complex systemic disorder that affects nearly seven million women of reproductive age in the United States. Among women in their twenties, thirties, and forties, “endo” is a leading cause of persistent, life-impacting symptoms, including:
Endometriosis is incurable, often progressive, and can be hard to live with — but luckily, it’s also treatable. In this month’s blog, our team at New Beginnings OB/GYN discusses the ins and outs of endometriosis care, including non-surgical options aimed at symptom relief.
Endometriosis occurs when tissue that’s similar to uterine lining (endometrium) grows outside the organ itself. These “endometrial implants” may appear on the outer surface of the uterus, or on the ovaries, fallopian tubes, diaphragm, lungs, bladder, intestines, or pelvic floor.
All endometrial tissue — even an implant growing outside the uterus — is responsive to the monthly female hormonal cycle, which prompts it to thicken with blood, break down, and shed. Shedding endometrium can leave your uterus via your vagina when you have your period, but shedding endometrial implants have no way to exit and remain trapped inside.
With nowhere to go, shedding implants may prompt the formation of adhesions (i.e., scar tissue) over time. The inflammatory, cyclical nature of endometrial implants, along with the adhesions they create, is what triggers endo pain and other symptoms.
Endometriosis doesn’t always require intervention — if the condition is mild and isn’t causing symptoms (or its symptoms are manageable), treatment may not be warranted.
But when endometriosis causes pain, conception difficulties, and diminished well-being, treatment can offer a path toward relief, fertility support, and a restored quality of life.
Endometriosis treatment falls into two categories: Minimally invasive surgery, which targets and removes endometrial implants, and non-surgical symptom management, which involves medications and complementary therapies.
Non-surgical endometriosis treatments aim to ease pain symptoms and improve related issues, like heavy periods, abnormal bleeding, GI distress, fatigue, and in one case, fertility. Let’s take a closer look:
Over-the-counter pain relievers — specifically non-steroidal anti-inflammatory drugs (NSAIDs) like Advil®, Motrin®, or Aleve® — can provide effective relief for mild to moderate endo pain and inflammation, including general pelvic pain and period-related pain.
Taking pain relievers for an extended period isn’t recommended, however, so it’s important to seek guidance from your gynecologist about NSAID use for ongoing endo symptom relief.
If you’re not trying to get pregnant, hormonal birth control medications can help you have lighter, less painful periods. You may benefit from an extended cycle (you have a few periods a year) or a continuous cycle (you never have periods) birth control with the combination pill (estrogen and progestin). When your period stops, endometrial implants stop growing, too.
Progestin-only birth control — available in the form of a pill, shot, implant, skin patch, vaginal ring, or IUD — can also deliver effective relief for heavy, painful periods.
Hormonal contraceptives don’t work as well for severe endometriosis symptoms, and only work well for mild to moderate symptoms for as long as they’re used. One caveat? Long-acting birth control methods like IUDs and implants are designed to prevent pregnancy for years at a time, but may not provide effective endo relief for that long.
Gonadotropin-releasing hormone (GnRH) drugs suppress the hormones that regulate your menstrual cycle, causing temporary menopause and stopping your periods. GnRH agonists are very effective at shrinking endometrial implants and alleviating endo pain, but shouldn’t be taken for longer than six months.
Because they halt implant progression, GnRH agonists are also the only non-surgical endometriosis treatment that can address fertility issues — many women find it easier to get pregnant after they stop taking the medication.
Complementary pain management options for endometriosis include acupuncture, massage therapy, chiropractic care, and pelvic floor physical therapy. These therapies can be used in conjunction with other treatments, too.
Some women also report greater symptom relief and improved well-being through healthy lifestyle practices, including an anti-inflammatory diet, regular exercise, improved sleep hygiene, and stress management.
Endometriosis can’t be cured, but we can help you manage it successfully. Non-surgical treatment solutions are usually the first treatment step, especially when symptoms aren’t severe enough to warrant early surgical intervention.
Is endo pain affecting your life? We’re here to help. Schedule a visit with Dr. Rania Ibrahim or Dr. Christina Parmar at New Beginnings OB/GYN in Shenandoah, Texas, today.