Medical Treatment for Endometriosis

This article focuses on medical treatment of endometriosis. Click here to find out about what endometriosis is, its symptoms and diagnosis.

How is endometriosis treated?

This depends on how severe your symptoms are, the stage of endometriosis, and your fertility plans. Endometriosis is a long-term condition. There is no cure and multiple surgeries are not recommended. The aim of treatment is to achieve surgical clearance at the most appropriate time, with hormonal medicines before and after that to suppress endometriosis.

Medical treatment

These suppress the symptoms of endometriosis and slow down its disease progression (i.e. slows down the deposit of endometriosis outside the uterus). They are hormones which need to be taken long-term, even if surgery has been done to clear endometriosis, unless you are trying to get pregnant, are pregnant or have reached menopause. This is because endometriosis is thought to be related to backflow of menstrual blood every month, leading to tissue from the womb lining being found outside the womb. This means that endometriosis has a high chance of recurring even after surgical clearance has been done if suppressive medications are not taken post-operatively.

Common options include:

• Visanne is commonly prescribed, and is an oral progestogen (1 pill daily) which reduces the pain and inflammation of endometriotic tissue. Women on Visanne either do not have periods, or more commonly experience irregular/prolonged spotting or bleeding. Visanne does not have birth control effects and women taking it need to use alternative birth control if they are not intending to get pregnant. 

• Mirena intrauterine device (IUD) is a hormone device that can be inserted in the clinic. It lasts for 5 years and has a local effect by releasing progestogen slowly from its location in the uterus. Women using Mirena may have very light periods or none at all. It also acts as a birth control method. 

• Birth control pills (OCPs): this is an oral combined estrogen/progesterone pill taken daily. It is best taken continuously until breakthrough bleeding occurs, following which a short 4-day pill-free break can be taken before resuming daily pill-taking. This also acts as a birth control method. 

Other forms may include progestogens in the form of injections – your doctor will discuss with you if you are suitable for it.

If you have advanced endometriosis with severe symptoms, or wish to conceive soon but have difficulty getting pregnant, you may require surgery.