Medicines and Products for Endometriosis

Endometriosis is managed long term. Treatment depends on symptoms, age, and whether you want to become pregnant. A gynaecologist should guide the plan.

Pain relief

• NSAIDs such as ibuprofen or mefenamic acid, taken at the start of pain and with food. Paracetamol can be added.
• Stronger pain medicines are used only under medical supervision. Nerve pain medicines may help some women with long-term pelvic pain.

Hormonal treatments (to reduce or stop periods and slow the disease)

• Combined contraceptive pill, often taken continuously.
• Progestins such as dienogest or norethisterone.
• Levonorgestrel intrauterine system (hormone coil).
• GnRH agonists and antagonists, including newer oral combinations, which lower oestrogen strongly. They are usually used for a limited time and may need "add-back" hormones to protect bones.
• These treatments control symptoms but do not cure endometriosis, and symptoms may return when they stop. They also prevent pregnancy while being used, except in some fertility plans.

Surgery

Keyhole (laparoscopic) surgery can remove or destroy patches, cysts and scar tissue. It is considered for severe pain, large ovarian cysts, deep disease, or fertility problems. Surgery should be done by an experienced surgeon. Symptoms can return later. Hysterectomy is a last resort and does not suit everyone.

Fertility

If trying to conceive, treatment may include surgery, ovulation support, IUI or IVF. A fertility specialist can advise.

What to avoid

• Taking leftover or borrowed hormonal tablets.
• Long-term daily painkillers without advice.
• Herbal "hormone balancing" products with big claims.

Ayurvedic products. None has been shown to treat endometriosis. If you take any, tell your gynaecologist, since some affect hormones or bleeding.