Easing the Pain of Endometriosis

Easing the Pain of Endometriosis Easing the Pain of Endometriosis

Millions of women with endometriosis suffer with chronic pain. Whether from severe menstrual cramping, pain during or after sexual intercourse, lower back pain, or constant pelvic pain, endometriosis can wreak havoc on a woman’s quality of life.

Pain and endometriosis symptoms
Pain is the most common endometriosis symptom. Ironically, the severity of endometriosis is not measured by the level of pain. Women can have no pain at all, yet endometriosis may be affecting a large segment of their internal organs. Likewise, some women with severe pain can have a milder case of endometriosis.

Areas of the body that are often affected by endometriosis include:

  • Bladder, bowel, or rectum
  • Cervix and vagina
  • Fallopian tubes or ovaries
  • Outer surface area of the uterus
  • Pelvic cavity lining

Endometriosis can result in mild, moderate or severe pain as well as the following symptoms:

  • Pain or cramping with the menstrual period
  • Pelvic pain or a nagging discomfort in the pelvic area
  • Lower back pain
  • Pain with sexual intercourse
  • Gastrointestinal (GI) pain in the intestinal tract
  • Pain with bowel movements and / or urination
  • GI symptoms such as constipation, bloating, and diarrhea
  • Nausea with the menstrual period
  • Bleeding, spotting, or discharge between periods
  • Feelings of fatigue or exhaustion
  • Infertility

If these symptoms sound familiar to you, make an appointment to see a fertility specialist to learn more.

Treating endometriosis pain
With endometriosis, a woman’s body produces more prostaglandins than normal. Prostaglandins are pro-inflammatory chemicals in the body that trigger pain. When prostaglandins are blocked, it results in less pain.

To block prostaglandins in the body, your doctor may prescribe OTC nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®). NSAIDs are also helpful in easing normal menstrual pain. If the NSAIDs are not helpful in easing pain, your doctor may prescribe a stronger pain medication.

Hormone therapy suppresses ovulation and pain
For women who are not trying to get pregnant, hormone therapy that suppresses ovulation may work to ease the pain of endometriosis. These treatments are sometimes helpful in breaking the pain cycle as they prevent hormones that signal endometrial tissue to grow and shed. Types of hormone therapy may include:

  • Birth control pills (oral contraceptives). Oral contraceptives halt ovulation. Birth control pills also stop menstruation and symptoms associated with endometriosis, including the mild to severe pain. Side effects of birth control pills may include headaches or nausea.
  • GnRH analogues (Lupron, Synarel and Zoladex). Estrogen is “fertilizer” for endometriosis. Reducing the production of estrogen decreases the stimulation for endometriosis to grow. The GnRH analogues block estrogen, which can result in menopausal symptoms like vaginal dryness, hot flashes, night sweats, and temporary bone loss. Women who take GnRH analogues should use this treatment with medications such as progestin, a synthetic form of progesterone, and/or a low dose estrogen, to ease the side effects. Progestins are known to cause weight gain or depression in some women, so talk to your doctor about the side effects before starting this treatment regimen. Also, GnRH  analogues should only be used for a six month period.
  • IUDs that contain progestin. These IUDs give off a type of progestin (called levonorgestrel) that works to repress ovulation, thus reducing pain and bleeding. To be effective, a new IUD must be inserted every five years in women under age 40.  

Most women with endometriosis have less pain during pregnancy. Because ovulation does not take place during pregnancy, the growth of the endometrium is halted.

Seek answers for endometriosis pain
There are answers—and effective treatment—for endometriosis. Talk with your doctor about the symptoms you experience and ask about treatments that may help.

If you are planning to get pregnant, your doctor may want to do treatments that will help you conceive quickly, as in some cases, endometriosis makes it difficult to get pregnant and have a baby.

Ask a doctor in your area about endometriosis

This content is Copyright The American Fertility Association (AFA) 2010. This content is intended for personal use and may not be distributed or reproduced without AFA consent. Please contact info@theafa.org or visit theafa.org for more information.

  • Endometriosis Research Center
  • The American Fertility Association Fact Sheet: Important Questions for Your Doctor. 
  • www.womenshealth.gov
  • www.healthywoman.org