Endometriosis is the second most common gynaecological disorder after fibroids, affecting as many as 1 in 10 women and AFABs. And that’s just the 10% that we know about. If you suffer from endometriosis, you probably know that the biggest symptom is pain… a lot of it. Experiencing such chronic pain amongst other symptoms can not only be damaging physically but decrease your effect your lifestyle dramatically. With little research and knowledge about the condition, it is difficult for both doctors and endo warriors to get a handle on managing endometriosis symptoms.  

Sadly, there is no current cure for endometriosis, however, there are different treatments and pain management techniques available, which aim to reduce the severity of symptoms and improve your quality of life. We’ve put together our top tips for managing endometriosis symptoms, and how to relieve the pain. 

Pharmacological endo management

There might not be a cure for endometriosis, but some pain relief sure goes a long way. Sometimes the only way to get you through those soul-sucking, intense cramps is with some good old over-the-counter painkillers. Your doctor may recommend you take some nonsteroidal anti-inflammatory drugs (NSAIDs) or paracetamol to first manage any endometriosis pain. 

Depending on the severity of your endometriosis pain, you may try a course of painkillers for three months until you assess whether or not they are working adequately. But if you’re finding that these aren’t quite making the cut, and you’re cancelling your weekend plans with your pals thanks to a flare-up, don’t suffer in silence! This is just the first option for managing endometriosis, so push your doctor for alternatives.

Hormone treatment to manage endometriosis

When you are diagnosed with endometriosis, hormone treatment is a common avenue your GP or specialist will lead you down, in addition to those all-important painkillers.

The lining of your womb consists of cells that respond to your sex hormones that rise and fall throughout your cycle causing the lining to thicken, break down and bleed. In those that have endometriosis, similar cells also exist outside of the womb (usually in the abdomen) which also bleed during your period. This bleeding cause inflammation, scarring and could also cause your organs to bind together – the cause behind your chronic pain. 

The aim of hormone treatment is to reduce or stop this bleeding so that these results are either reduced or stopped completely. Whilst most endo warriors find that hormonal treatment reduces their symptoms, it is not a permanent fix to manage endometriosis.

Different types of hormonal treatment used to manage endometriosis include:

  • The combined pill (oestrogen and progesterone) 
  • The mini-pill (progesterone only)
  • An inter-uterine system (IUS): a small plastic device fitted into the womb and lasts for 5 years 
  • Progesterone injections, administered into the bottom every 12 weeks
  • The progesterone implant, placed in your arm and lasts for 3 years

Unfortunately, not everyone gets on with hormonal contraception and there is a slight chance you could experience some side effects.  So it’s important to consider which hormone treatment is right for you. 

Surgery – eek!

A last-resort if the above treatments don’t make the cut. 

Initial surgery will almost always involve gynaecological laparoscopy for both diagnosis and excision. In laparoscopic surgery, your surgeon inserts a slim viewing instrument (laparoscope) through a small incision near your navel and uses tools to remove the endometrial tissue through another incision closeby. 

This form of surgery can be difficult, as many of the lesions are below the surface and not visible, and so a highly skilled practitioner is required to remove them. For some endometriosis sufferers, their lesions could have spread to the rectum and other pelvic regions that would require surgical attention from a team of experts. After your surgery is complete, your doctor may also recommend taking hormone medication to help improve pain.

Surgery might be the last resort, but it also been proven to have the most benefits for treating and managing endometriosis. It might be the most long-lasting treatment, but many who undergo surgery find their endometriosis grows back over time. This is why it is common for our endo warriors to find themselves going under the knife more than once. 

Pain pain, go away!

And then there are the days where popping pills doesn’t quite cut it and your endo pain has you bed-bound. What do you do? 

Endometriosis UK suggests some extra tips for pain management:

  • Heat and comfort → Hot water bottles or heated wheat bags partnered with your comfies will help get you feeling more comfortable – time to ditch the jeans and get those trackies on! 
  • Physiotherapy → Physiotherapists can develop a programme of exercise and relaxation techniques designed to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety.
  • Pain modifiers → such as Tricyclic antidepressants. These alter the body’s perception of pain by tricking the nervous system.
  • Transcutaneous Electrical Nerve Stimulator (TENS) machines → a small machine with electrodes that send electrical pulses into the body, hopefully blocking the pain messages as they travel through your nerves.
  • Pain clinics → GP’s can refer you to your nearest pain clinic to see chronic pain specialists. Push for your doctor to get you the expert advice you deserve to manage your endometriosis.  

Is your endo pain too much? Feel like you’re getting nowhere with your doctors? At Hertility, we don’t believe in ignoring or masking your symptoms. We don’t just give you results, we give you the what’s up and the what’s next. Our team of experts include endometriosis specialists that can help you decide the treatment plan that suits you best whether it’s surgery, hormone treatment or pain relief.

Resources

https://www.nice.org.uk/guidance/ng73/resources/patient-decision-aid-hormone-treatment-for-endometriosis-symptoms-what-are-my-options-pdf-4595573197
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700667/
https://www.nice.org.uk/guidance/ng73/chapter/Recommendations#pharmacological-pain-management