If you have endometriosis, there is always a choice whether or not to have treatment and, if so, what type. You will decide with your doctor what to do, and your choice will be guided by your symptoms and whether you want to become pregnant.
The aim of treatment is to relieve symptoms and preserve or restore fertility. Medical treatments include pain relievers, hormonal treatment and surgery. There is no treatment suitable for every case, and no guaranteed cure.
In mild cases with few or no symptoms it may be appropriate to wait and see if the disease gets better or progresses. You’ll need regular checks, and if there’s no improvement you’ll probably accept more active treatment.
Another option is to relieve pain without treating the disease by taking pain relievers and/or anti-inflammatory drugs. This may be suitable if the pain is mild or if you’re near the menopause, after which symptoms usually subside. Other measures that help with any chronic pain, such as heat pads or a hot-water bottle, massage, yoga, meditation and acupuncture have brought relief to some sufferers.
The hormones used to treat endometriosis either prevent the production of oestrogen or counteract its effect. Without oestrogen, endometrial tissue doesn’t grow and the endometrial deposits outside the uterus become inactive and shrink.
Hormonal treatments used in Australia include danazol (Danocrine, Azol) and progestogens (Duphaston, Primolut N, Provera, Depo-Provera). Danazol is a weak male hormone that reduces the amount of oestrogen produced by the оvaries to postmenopausal amounts. Progestogens also reduce oestrogen production (though not as much as danazol does) and if taken continuously prevent breakdown of endometrial tissue. Sometimes the combined oral contraceptive Pill, taken continuously, is used to stop endometrial breakdown.
All hormonal treatments take six weeks to relieve symptoms used in courses of 3-12 months have side-effects: if hormonal treatment is suggested, you should be told what side-effects to expect. The condition can relapse after hormonal treatment is stopped.
Surgery may be needed to remove tissues affected by endometriosis: not only the deposits and cysts, but also adhesions within the pelvis and abdomen. It is often combined with hormonal treatment.
Some women try alternative therapies for endometriosis. These include a variety of diets, vitamin and supplements; naturopathy; homeopathy; osteopathy; herbal remedies. Many of
these therapies include counselling about self-esteem and lifestyle and can lead to new, beneficial attitudes to life and health, but I’ve heard no evidence that any alternative treatment (except some herbal extracts that contain hormones) сan influence the course of endometriosis.