Endometriosis: 5 Ways to Manage Pain

Endometriosis is a condition where tissue similar to the lining of the uterus starts to grow outside of the uterus. Typically, it grows in areas like the ovaries, fallopian tubes, and the tissue that lines your pelvis, but cases have been found in nearly every organ of the body. Endometriosis can cause severe pain, especially when menstruating. Fortunately, there are effective treatments to help manage symptoms.

How does it happen?

The inner lining of the uterus, known as the endometrium, is a key player in the reproductive system. With each menstrual cycle, endometrial tissue thickens and renews itself in preparation to receive an embryo. During pregnancy, it provides an embryo or fetus with vital oxygen and nutrients.

While the tissue involved in endometriosis is not exactly endometrial tissue, it looks and acts similarly. During the menstrual cycle, this tissue can become inflamed and lead to swelling and scarring of the healthy tissue around the deposits. If affecting the ovaries, cysts can form called endometriomas.

Pain Management

Each case of endometriosis is different. Therefore, treatments that are effective in relieving the symptoms of one person might not have the same effect on another. It is important to work with a health care provider to develop personalized treatment plans that can help relieve your symptoms.

NOTE: It is important to remember that these therapies do not stop progression or offer a “cure” for endometriosis. However, they can provide a break in symptoms that patients might find helpful for their physical and mental health.

Below are 5 different ways to manage pain from endometriosis, from simple solutions to more advanced treatment options:

1. Heat and comfort: Applying heat to the lower abdomen by using a heating pad or taking a warm bath can increase blood flow and relax muscle contractions, both of which can help reduce pain.

2. Over-the-counter pain medication: Taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or other over-the-counter pain relievers can help during a flare-up. However, these should only be considered as a short-term solution as NSAIDs should not be taken more than 10 days in a row for pain unless directed by a physician.

3. Lifestyle changes: While the following lifestyle changes will not cure or reduce endometriosis, they might help ease some of the associated pain and improve mental health.

• • Exercise. Some studies show a moderate improvement in pain for individuals that engage in regular physical activity¹. As an added benefit, exercise has also been shown to reduce depression and anxiety². This is especially important as individuals experiencing chronic pain like endometriosis are at a higher risk of developing these conditions.
  • Diet. It is common for people with endometriosis to experience gastrointestinal symptoms like constipation, bloating, diarrhea, and nausea, which contribute to pain experienced with endometriosis. Some find that following a low FODMAP diet helps reduce these symptoms³. FODMAP stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols”, which are sugars that produce large amounts of uncomfortable gas when digested in the bowel and can cause gas, pain and diarrhea.
  • Stress relief. Stress can increase overall inflammation in the body, which might exacerbate symptoms of endometriosis. Reducing stress through things like yoga, getting good-quality sleep, and practicing mindfulness may be beneficial for those with this condition.

4. Hormone therapy: some hormone treatments have been shown to reduce pain associated with endometriosis

• • Birth control. Birth control. Contraceptives containing the hormones estrogen and/or progestin (the synthetic form of progesterone) can be prescribed to help lighten and shorten menstruation. Progestins alone, taken as a pill, injection, or intrauterine device (IUD), has also been shown to reduce endometriosis pain.
  • Gonadotropin-releasing hormone (GnRH) medication. Medication called elagolix (brand name Orilissa) suppresses the production of certain hormones from the ovaries, which stops ovulation and menstruation. This causes the body to go into a “menopausal” state and can slow the growth of endometriosis.
  • Testosterone therapy. While some think of testosterone as a ‘male’ hormone, all individuals have testosterone. The medication Danazol (brand name Danocrine) stops the release of hormones involved in the menstrual cycle to lighten or stop periods.

5. Surgical treatment: Studies show that certain surgical treatments can provide significant relief from severe endometriosis pain. Though, this is only a short-term solution. During surgery, a physician can examine the tissue growths and remove them if necessary.Physicians typically suggest the following surgical treatments:
   • A Laparoscopy is a minimally invasive procedure where the surgeon can remove the lesions and scar tissue manually or destroy them using intense, focused heat.
   • A Laparotomy is a surgical procedure where a large incision is made in the abdomen. This may be used if the lesions are too small to be seen through a laparoscopy.

   Some surgical procedures cannot be reversed and can impact fertility. Therefore, it is important to discuss all options with your healthcare provider before deciding on a treatment.

Takeaway

Everyone’s experience with endometriosis is different. While this condition does not currently have a cure, your healthcare provider can help develop treatment plans targeted to your specific needs and future family-building goals.

Resources & Support Groups

Endo Network of Canada

Endo Foundation of Canada

Nancy’s Nook

Endo Education Organization of Canada

Extra Pelvic Not Rare

Endo Support Group

Do you have more questions about endometriosis? Our fertility specialists are happy to answer them. Book a consultation today!