There is no cure for endometriosis. However, there are many treatment options, both medical and surgical, which can help to relieve the symptoms.

The choice of treatment will depend on a number of things such as:

• Age
• Type of symptoms
• Severity of symptoms
• Desire to have children

Patients need to discuss with their doctor the best treatment option(s) for them.

MYTH Pregnancy will cure endometriosis FACT Although following pregnancy some women can be symptom free for long periods, for many women endometriosis returns.

Analgesics – in women with mild pain, the use of simple, over the counter analgesics such as paracetamol (acetaminophen) or non-steroidal anti-inflammatory analgesics (e.g. ibuprofen) may provide relief. If these are not effective there are stronger analgesics that can be prescribed by the doctor.

Hormonal Treatments – these provide symptom relief by reducing the levels or decreasing the effect of oestrogen in order to prevent ovulation. This prevents the endometrial implants from growing and allows them to shrink.

Hormonal treatments are generally only effective while they are being taken. Once treatment stops, symptoms generally return.

There are a number of hormonal treatment options:

• Oral Contraceptives (The Pill) - which prevent ovulation 
• Progesterone preparations e.g. medroxyprogesterone acetate (MPA) – which acts in a similar way to the Pill
• Gonadotrophin Releasing Hormone analogues (GnRHa’s) e.g. goserelin (ZOLADEX), which is given as an injection either every 4 weeks or every 3 months and reduces oestrogen levels and relieves the clinical symptoms of endometriosis.
• Male hormones e.g. danazol – which lower oestrogen levels.

Surgery – this is usually the best option for women with large amounts of endometrial tissue, severe pain or in those who wish to become pregnant.

This can be achieved by:

• Laparoscopy – using key-hole surgery and a laser to remove tissue
• Laparotomy – which is major surgery and allows the removal of larger amounts of tissue. 
• Hysterectomy – this is the complete removal of uterus, ovaries and fallopian tubes and is only considered as a last resort and by women who do not want to become pregnant.

Combination Therapy – combining both hormonal therapy (e.g. goserelin) to reduce the size and amount of tissue followed by surgery to remove the tissue can be a useful treatment option.

Complementary Therapies – whilst there is no clinical evidence to support their use, some women have tried various treatments such as acupuncture, aromatherapy, homeopathy and reflexology.

Patients need to discuss with their doctor the best treatment option(s) for them.