The main symptom of endometriosis is pelvic pain – there are various pain relief and pain management options available.
See our list of pain relief and pain management options below.
- Heat and comfort
- Painkillers
- Physiotherapy
- Pain modifiers
- Heat and comfort: A simple hot water bottle or hot bath may help to reduce pain. Some women also find heated wheat bags to be effective.. Being comfortable and reducing stress will also be beneficial.
- Painkillers: Anti-inflammatory drugs such as Ibuprofen, Voltarol and Ponstan (mefanemic acid) block the production of prostaglandins in the body. Prostaglandins occur naturally, in response to injury or disease, and cause pain and inflammation. They have a number of functions including making the womb contract during a period (which helps with the shedding of the womb lining). These contractions can cause pain. It is thought that women with endometriosis may produce more prostaglandins than women without the condition.
Anti-inflammatory drugs only work effectively if they are taken before the body produces prostaglandins. It is best to start taking anti-inflammatory drugs the day before, or several days before, a period or pain is expected. Common side effects of such drugs include nausea, vomiting, diarrhoea, stomach upsets and stomach ulcers. These side effects can be reduced by taking the drugs with food or milk.
Codeine-based painkillers are effective painkillers but can cause constipation and gastro-intestinal upset, which may aggravate symptoms in women with endometriosis. Also, simple analgesics such as paracetamol can be used to treat mild pain.
- 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. After surgery, rehabilitation in the form of gentle exercises, yoga, or Pilates can help the body get back into shape by strengthening compromised abdominal and back muscles.
- Pain modifiers: These drugs work by altering the body’s perception of pain. Tricyclic anti-depressants (example – Amitriptyline) are drugs that are mainly used to treat depression but have been found to have an effect on the nervous system and the way the body manages pain. The pain messages travel through the body’s central nervous system, but these drugs can help to stop those messages from reaching the brain.
Treatment will vary from woman to woman and is often determined by the patient’s priorities. For instance, if a woman is planning to try and become pregnant soon, none of the hormonal treatments are suitable as they either act as a contraceptive or halt the menstrual cycle. The type of treatment should be decided in partnership between the patient and the healthcare professional. The decision should depend on several factors:
- The age of the woman
- The severity of her symptoms
- The desire to have children, and when
- The severity of the disease
- Previous treatment
- The woman’s priorities – pain relief or fertility
- Side effects of drugs
- Risks
- Intended duration of treatment
Other treatment options include:
- Nutrition
- Complementary therapies
- Emotional support