Materiały źródłowe

• #1 Treatment of endometriosis: a review with comparison of 8 guidelines | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01545-5

  Endometriosis, the presence of endometrial-like tissue outside the uterus, is a common clinical entity between women of reproductive age, with a prevalence of about 10%. Due to the variety of endometriosis-associated symptoms, a great variety of treatments have been implemented. The aim of this review is to give an overview on therapeutical approaches of eight national and international widely used guidelines. […] All the above-mentioned guidelines agree that the combined oral contraceptive pill, progestogens are therapies recommended for endometriosis associated pain. Concerning infertility, there is no clear consensus about surgical treatment. Discrepancies are also found on recommendation of the second- and third-line treatments. […] All the included guidelines recommend laparoscopic surgery in preference to laparotomy for chronic pain of endometriosis and infertility, because of less pain, shorter duration of hospitalisation, quicker recovery and better cosmetic result.

• #2

  https://www.who.int/news-room/fact-sheets/detail/endometriosis

  There is currently no known cure for endometriosis and treatment is usually aimed at controlling symptoms. […] Treatments to manage endometriosis can vary based on the severity of symptoms and whether pregnancy is desired. No treatments cure the disease. […] A range of medications can help manage endometriosis and its symptoms. […] Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics (painkillers) like ibuprofen and naproxen are often used to treat pain. […] Hormonal medicines like GnRH-analogues and contraceptive (birth control) methods can also help control pain. […] Fertility medicines and procedures are sometimes used for those having difficulty getting pregnant because of endometriosis. […] Surgery is sometimes used to remove endometriosis lesions, adhesions and scar tissues.

• #3

  https://www2.hse.ie/conditions/endometriosis/treatment/

  There is currently no cure for endometriosis and it can be difficult to treat. There are treatments that can help ease and manage the symptoms of endometriosis and slow down the progression of the disease. […] Treatment can be given to: relieve pain, slow the growth of endometriosis tissue, improve fertility, reduce the likelihood of the condition returning. […] Treatments include: painkillers and anti-inflammatories ibuprofen, paracetamol hormone medicines, contraceptives such as the oral contraceptive pill, surgery to remove patches of endometriosis tissue, often by keyhole surgery. […] In extreme cases, you may need an operation to remove the endometriosis tissue on the affected organs. Most women with endometriosis will not need an operation to manage their symptoms. Your doctor will discuss the best options with you for your situation.

• #4 Treatment and Management | Endometriosis UK

  https://www.endometriosis-uk.org/treatment-and-management

  If you have been diagnosed with endometriosis, your doctor or specialist should discuss possible endometriosis treatment options with you. […] Currently, there is no cure for endometriosis. The different treatments available for endometriosis aim to reduce the severity of symptoms and improve the quality of life for someone living with the condition. […] The type of treatment you receive for your endometriosis should be decided in partnership between you and your healthcare professional. Your healthcare professional will consider many different factors when working out the best endometriosis treatment method for you, such as your age, the severity of endometriosis you have and the severity of your symptoms. […] We do not recommend any particular treatment for endometriosis, but support patients seeking treatment options appropriate to their individual circumstances. […] Treatment options available to those with endometriosis are: Hormone treatments for endometriosis Pain Relief for endometriosis.

• #5 Endometriosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661

  Treatment for endometriosis often involves medicine or surgery. The approach you and your health care team choose will depend on how serious your symptoms are and whether you hope to become pregnant. […] Typically, medicine is recommended first. If it doesn’t help enough, surgery becomes an option. […] Your health care team may recommend pain relievers that you can buy without a prescription. These medicines include the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve). They can help ease painful menstrual cramps. […] Your care team may recommend hormone therapy along with pain relievers if you’re not trying to get pregnant. […] Sometimes, hormone medicine help ease or get rid of endometriosis pain. The rise and fall of hormones during the menstrual cycle causes endometriosis tissue to thicken, break down and bleed. Lab-made versions of hormones may slow the growth of this tissue and prevent new tissue from forming.

• #6 Endometriosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10857-endometriosis

  Endometriosis causes tissue that is similar to the lining of the uterus to grow in other places where it doesn’t belong. Treatment for endometriosis involves medication, surgery or a combination of both. […] In many cases, your treatment plan will focus primarily on managing your pain and improving fertility issues (if you’re planning on a future pregnancy). Medication and surgery (or both) are possible treatment options. […] Medications can help manage the symptoms of endometriosis. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be helpful with pain. Hormonal therapies are another option. They can help with pain and with suppressing your menstrual cycle. […] In some cases, your provider might recommend surgery to treat endometriosis. There are always risks to a surgical procedure. But surgery for endometriosis can be an effective way to relieve pain and, in some cases, improve your fertility. The goal of surgery is to remove the endometriosis tissue.

• #7 Endometriosis: Learn More – Treating endometriosis with medication – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279498/

  Endometriosis can be treated with various kinds of medication. The most common of these are painkillers and hormone-based treatments containing progestins or GnRH analogs. But these only work for as long as you use them. […] The treatment options for endometriosis will greatly depend on your personal situation. If symptoms like pain and cramping are the main problem, many different symptom-relieving treatments can be considered. These include painkillers, hormone therapy and surgery. […] Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs) are often used to treat endometriosis. […] Although NSAIDs have been proven to relieve period pain, there’s hardly any good-quality research on their effect in women with endometriosis. […] If these painkillers don’t help enough, drugs known as opioids can sometimes be used.

• #8 Endometriosis: Learn More – Treating endometriosis with medication – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279498/

  Distressing, chronic pain can sometimes be treated with other kinds of medication such as antidepressants or anti-epileptic drugs even if you don’t have depression or epilepsy. […] Hormone-based medications lower the level of the hormone estrogen, which regulates this cycle. In this way, hormone therapy inhibits the monthly build-up of endometriosis tissue. […] The hormone therapy options in endometriosis include: Progestins, GnRH antagonists, GnRH agonists, Combined hormonal contraceptives. […] Hormone therapy can prevent endometriosis tissue from building up, which relieves the pain. […] Drugs containing the hormone progestin can relieve pain in endometriosis. […] The birth control pill (combination pill) can relieve endometriosis-related pain. […] GnRH agonists can relieve endometriosis-related symptoms too. […] GnRH antagonists reduce the amount of reproductive hormones secreted by the pituitary gland at the base of the brain.

• #9 Endometriosis: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1000/endometriosis.html

  Endometriosis is an inflammatory condition caused by the presence of endometrial tissue in extra-uterine locations and can involve bowel, bladder, and all peritoneal structures. […] Diagnosis of endometriosis in the primary care setting is clinical and often challenging, frequently resulting in delayed diagnosis and treatment. […] Combined hormonal contraceptives with or without nonsteroidal anti-inflammatory drugs are first-line options in managing symptoms and have a tolerable adverse effect profile. […] Second-line treatments include gonadotropin-releasing hormone (GnRH) receptor agonists with add-back therapy, GnRH receptor antagonists, and danazol. […] Aromatase inhibitors are reserved for severe disease. […] All of these treatments are effective but may cause additional adverse effects.

• #10 Endometriosis: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1000/endometriosis.html

  Referral to gynecology for surgical management is indicated if empiric therapy is ineffective, immediate diagnosis and treatment are necessary, or patients desire pregnancy. […] Hormonal therapy is the mainstay of treatment and focuses on suppressing estrogen, inhibiting tissue proliferation, and reducing inflammation. […] Combined hormonal contraceptives, including oral pills, transdermal patches, and vaginal rings, are considered first-line therapies. […] Progestin-only methods (i.e., oral, depot, implant, or hormonal intrauterine systems) are other first-line options that may be considered for those who cannot tolerate or have contraindications to estrogen. […] Second-line treatment options include gonadotropin-releasing hormone (GnRH) receptor agonists with add-back therapy, GnRH receptor antagonists, and danazol.

• #11 Treatment of endometriosis: a review with comparison of 8 guidelines | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01545-5

  All eight guidelines recommend progestins as first-line medical treatment for pain in endometriosis. […] The combined oral contraceptive pill (COC) is a widespread contraceptive method which is also used widely from clinicians empirically in patients with dysmenorrhea. Most of the included guidelines propose combined oral contraceptives as a first empirical medical treatment in endometriosis associated pain before performing diagnostic laparoscopy although the reported level of evidence differs. […] GnRH agonists use in endometriosis patients is reserved for patients with persistent symptoms after the use of first line therapy. All the above societies agree that GnRH agonists can reduce the endometriosis associated pain. […] Aromatase inhibitors reduce endometriosis-associated pain, intestinal symptoms, urinary symptoms and decrease the volume of laparoscopically visible endometriosis, rectovaginal infiltrating endometriosis and endometriomas. […] Conclusively, this is a review and summary of the eight most widely accepted guidelines concerning the management of endometriosis. Pain and infertility are the major components of endometriosis that most usually lead patients in seeking an expert opinion.

• #12 Evaluation and Treatment of Endometriosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0115/p107.html

  Combination oral contraceptives are more effective than placebo at reducing dysmenorrhea in women with endometriosis. […] Medroxyprogesterone (oral [Provera] or depot injection [Depo-Provera]) may improve symptoms of endometriosis compared with placebo. […] If NSAIDs and hormonal contraceptives are ineffective, the next step is treatment with a GnRH analogue such as leuprolide or goserelin (Zoladex). […] Danazol, an androgen, is effective in the treatment of pelvic pain associated with endometriosis. […] Laparoscopic ablation of deposits and excision of endometriomas are options to relieve pain and treat infertility. […] Several medications are under evaluation for the treatment of endometriosis, including mifepristone (Mifeprex); aromatase inhibitors; Chinese herbal medications; gestrinone; immunomodulators; and selective estrogen receptor modulators.

• #13 Open Search

  https://www.plannedparenthood.org/learn/health-and-wellness/endometriosis/how-endometriosis-diagnosed-and-treated

  A doctor will examine you and may do a minor surgical procedure called laparoscopy to see if you have endometriosis. Endometriosis treatment can include medicine or surgery. […] Endometriosis cant be cured, but it can be treated with medicine or surgery. If your symptoms arent too bad, pain relievers may be enough to help. If you dont want to get pregnant right now, your doctor or nurse can prescribe hormonal birth control (like the pill or a hormonal IUD) to cut down on pain and bleeding. There are other medications you can take for endometriosis if youre trying to get pregnant. […] Surgery for endometriosis may be an option for you if your symptoms are really bad or if you want to get pregnant but havent been able to. A surgeon will remove the growths that are outside of your uterus, cutting down on pain and making it easier for you to get pregnant. But often the growths come back after surgery, so you may need to take medication, too. As a last resort, some people have a hysterectomy removing the uterus and sometimes the ovaries, though its impossible to become pregnant after that.

• #14 Endometriosis Medical Treatment – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/medical-treatment-for-endometriosis

  Medications containing a combination of an estrogen and a progestin can be used to control your periods and suppress the activity of endometriosis. […] Continuous combined estrogen and progestin therapy is safe and well-tolerated by most women. […] Progestins alone are also effective in treating endometriosis. […] Each of these progestin-only methods can make your periods lighter and less frequent or stop them altogether. […] Danazol is a synthetic androgen (male hormone) which is an effective medical treatment for endometriosis. […] Another highly effective way to treat endometriosis is to lower the natural estrogen levels altogether by giving an injectable medication, called leuprolide acetate (Lupron).

• #15 How is Endometriosis Treated? – Your Period

  https://www.yourperiod.ca/endometriosis/how-is-endometriosis-treated/

  Progestin therapy, such as a progestin-only birth control pill, an oral pill (e.g., Dienogest or Noresthisterone acetate), or an injection, can help lessen the effects of estrogen that stimulate endometriotic growth. […] An intrauterine device (IUD) may be recommended if combined hormonal contraception or progestin therapy is not effective to manage your symptoms. […] Gonadotropin releasing hormonal (GnRH) agonists with add back therapy, given by injection or nasal spray, will similarly cause you to stop menstruating and may relieve symptoms of endometriosis. […] GnRH antagonists may also be recommended to treat painful symptoms experienced due to endometriosis. […] Danazol was once one of the most common medical treatments for endometriosis. […] If your endometriosis symptoms persist despite medication or other forms of treatment, surgery to remove endometriosis growth and scar tissue may be helpful.

• #16 Management and treatment of endometriosis | Jean Hailes… | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/endometriosis/management-treatment

  Progestogens (natural and synthetic forms) provide pain relief for many women with endometriosis. […] GnRHa treatment is usually used for moderate to severe endometriosis. […] GnRHa stops ovulation, which results in reduced oestrogen hormone levels in the body. This slows or stops the growth of the endometrial tissue, causing it to gradually shrink and disappear. […] Endometriosis usually goes away after menopause. While uncommon, it can return with the use of menopausal hormone therapy (MHT), especially if the therapy doesn’t include progestogen. […] Most surgery for endometriosis is performed via keyhole surgery (laparoscopy). The goal of surgery is to achieve the best outcome and reduce the need for more operations in the future. […] Many studies have shown that surgery improves symptoms and overall quality of life for women with endometriosis.

• #17 Evaluation and Treatment of Endometriosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0115/p107.html

  Combination oral contraceptives are more effective than placebo at reducing dysmenorrhea in women with endometriosis. […] Medroxyprogesterone (oral [Provera] or depot injection [Depo-Provera]) may improve symptoms of endometriosis compared with placebo. […] If NSAIDs and hormonal contraceptives are ineffective, the next step is treatment with a GnRH analogue such as leuprolide or goserelin (Zoladex). […] Danazol, an androgen, is effective in the treatment of pelvic pain associated with endometriosis. […] Laparoscopic ablation of deposits and excision of endometriomas are options to relieve pain and treat infertility. […] Several medications are under evaluation for the treatment of endometriosis, including mifepristone (Mifeprex); aromatase inhibitors; Chinese herbal medications; gestrinone; immunomodulators; and selective estrogen receptor modulators.

• #18 Endometriosis Treatment & Management: Approach Considerations, Hormonal Therapy, Surgical Intervention

  https://emedicine.medscape.com/article/271899-treatment

  COCPs act by ovarian suppression and continuous progestin administration. Initially, a trial of continuous or cyclic COCPs should be administered for 3 months. With pain relief, this treatment is continued for 6-12 months. Pregnancy rates following discontinuation of the pill are 40-50%. […] The levonorgestrel intrauterine system (LNG-IUS) has been shown to reduce endometriosis-associated pain. When inserted at the time of laparoscopic surgery, it has been found to reduce the recurrence of dysmenorrhea by 35%. […] GnRH analogues produce a hypogonadotrophic-hypogonadic state by downregulation of the pituitary gland. Goserelin and leuprolide acetate are the commonly used agonists. Efficacy is limited to pain suppression, and fertility rates may show no improvement. […] Elagolix is an oral GnRH receptor antagonist that inhibits endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. It was approved by the FDA in July 2018 for management of moderate to severe pain associated with endometriosis.

• #19 Endometriosis Treatment & Management: Approach Considerations, Hormonal Therapy, Surgical Intervention

  https://emedicine.medscape.com/article/271899-treatment

  COCPs act by ovarian suppression and continuous progestin administration. Initially, a trial of continuous or cyclic COCPs should be administered for 3 months. With pain relief, this treatment is continued for 6-12 months. Pregnancy rates following discontinuation of the pill are 40-50%. […] The levonorgestrel intrauterine system (LNG-IUS) has been shown to reduce endometriosis-associated pain. When inserted at the time of laparoscopic surgery, it has been found to reduce the recurrence of dysmenorrhea by 35%. […] GnRH analogues produce a hypogonadotrophic-hypogonadic state by downregulation of the pituitary gland. Goserelin and leuprolide acetate are the commonly used agonists. Efficacy is limited to pain suppression, and fertility rates may show no improvement. […] Elagolix is an oral GnRH receptor antagonist that inhibits endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. It was approved by the FDA in July 2018 for management of moderate to severe pain associated with endometriosis.

• #20 LUPRON DEPOT® – Treatment for Endometriosis

  https://www.luprongyn.com/lupron-for-endometriosis

  LUPRON DEPOT can help reduce endometriosis pain. By suppressing the hormones that feed endometriosis, LUPRON DEPOT injections can help reduce your endometriosis pain and reduce the size of endometriotic lesions. In 2 studies of women undergoing endometriosis treatment with LUPRON DEPOT 3.75 mg for 6 months, 96% of women had relief from painful periods after their initial 6 months of therapy. Many also experienced relief from painful intercourse, pelvic tenderness, and pelvic pain. […] When LUPRON DEPOT is used alone, bone thinning and hot flashes can occur. Along with LUPRON DEPOT injections, your doctor may prescribe Add-back therapy. Add-back is a daily pill that you take while on LUPRON DEPOT therapy to add back a small amount of the hormone progestin, which can help you manage certain side effects, without interfering with the way LUPRON DEPOT works. Add-back may be prescribed from Day 1 of initial treatment with LUPRON DEPOT.

• #21 Endometriosis Treatment & Management: Approach Considerations, Hormonal Therapy, Surgical Intervention

  https://emedicine.medscape.com/article/271899-treatment

  COCPs act by ovarian suppression and continuous progestin administration. Initially, a trial of continuous or cyclic COCPs should be administered for 3 months. With pain relief, this treatment is continued for 6-12 months. Pregnancy rates following discontinuation of the pill are 40-50%. […] The levonorgestrel intrauterine system (LNG-IUS) has been shown to reduce endometriosis-associated pain. When inserted at the time of laparoscopic surgery, it has been found to reduce the recurrence of dysmenorrhea by 35%. […] GnRH analogues produce a hypogonadotrophic-hypogonadic state by downregulation of the pituitary gland. Goserelin and leuprolide acetate are the commonly used agonists. Efficacy is limited to pain suppression, and fertility rates may show no improvement. […] Elagolix is an oral GnRH receptor antagonist that inhibits endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. It was approved by the FDA in July 2018 for management of moderate to severe pain associated with endometriosis.

• #22 ORILISSA® (elagolix) to Manage Moderate to Severe Endometriosis Pain

  https://www.orilissa.com/

  ORILISSA (elagolix) is a prescription medicine used to treat moderate to severe pain associated with endometriosis. […] An oral pill specifically designed to reduce moderate to severe endometriosis pain. […] ORILISSA may cause serious side effects, including bone loss and effects on pregnancy: […] Do not take ORILISSA if you are trying to become or are pregnant, as your risk for early pregnancy loss may increase. […] ORILISSA does not prevent pregnancy. You will need to use effective hormone-free birth control (such as condoms or spermicide) while taking ORILISSA and for 28 days after stopping ORILISSA. […] ORILISSA can cause serious side effects including: […] The most common side effects of ORILISSA include: hot flashes and night sweats, headache, nausea, difficulty sleeping, absence of periods, anxiety, joint pain, depression, and mood changes.

• #23 Endometriosis Medical Treatment – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/medical-treatment-for-endometriosis

  Medications containing a combination of an estrogen and a progestin can be used to control your periods and suppress the activity of endometriosis. […] Continuous combined estrogen and progestin therapy is safe and well-tolerated by most women. […] Progestins alone are also effective in treating endometriosis. […] Each of these progestin-only methods can make your periods lighter and less frequent or stop them altogether. […] Danazol is a synthetic androgen (male hormone) which is an effective medical treatment for endometriosis. […] Another highly effective way to treat endometriosis is to lower the natural estrogen levels altogether by giving an injectable medication, called leuprolide acetate (Lupron).

• #24 Evaluation and Treatment of Endometriosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2013/0115/p107.html

  Combination oral contraceptives are more effective than placebo at reducing dysmenorrhea in women with endometriosis. […] Medroxyprogesterone (oral [Provera] or depot injection [Depo-Provera]) may improve symptoms of endometriosis compared with placebo. […] If NSAIDs and hormonal contraceptives are ineffective, the next step is treatment with a GnRH analogue such as leuprolide or goserelin (Zoladex). […] Danazol, an androgen, is effective in the treatment of pelvic pain associated with endometriosis. […] Laparoscopic ablation of deposits and excision of endometriomas are options to relieve pain and treat infertility. […] Several medications are under evaluation for the treatment of endometriosis, including mifepristone (Mifeprex); aromatase inhibitors; Chinese herbal medications; gestrinone; immunomodulators; and selective estrogen receptor modulators.

• #25 Endometriosis: Evaluation and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1000/endometriosis.html

  Aromatase inhibitors are reserved for patients with severe, refractory, endometriosis-related pain. […] Surgical management is indicated if empiric therapy is ineffective, if medical management is not tolerated, or to immediately diagnose and treat the patient, as in the case of an adnexal mass or treatment of infertility. […] Surgical excision of endometriotic tissue for treatment of pain was thought to be effective. […] However, based on limited evidence, an updated Cochrane review reported uncertainty about whether laparoscopic surgery (i.e., excision or ablation of endometriotic lesions) improves endometriosis pain at six and 12 months compared with diagnostic laparoscopy alone. […] For patients with endometriosis who do not desire future pregnancy and in whom all medical treatments and conservative surgical management options have failed, a hysterectomy with bilateral salpingo-oophorectomy is effective in the treatment of pain. […] Alternative treatments for endometriosis such as acupuncture, exercise, and dietary changes may help improve pain symptoms, although there is limited evidence to support these alternatives.

• #26 Endometriosis Treatment & Management: Approach Considerations, Hormonal Therapy, Surgical Intervention

  https://emedicine.medscape.com/article/271899-treatment

  The dependence of endometriosis on the woman’s cyclic production of menstrual cycle hormones provides the basis for medical therapy. Thus, combination oral contraceptive pills (COCPs), danazol, progestational agents, and gonadotropin-releasing hormone (GnRH) analogues form the mainstay of medical therapy. All these treatments have similar clinical efficacy in terms of reduction in pain-related symptoms and duration of relief. […] Nonsteroidal anti-inflammatory agents (NSAIDs) have not been shown to have any benefit in placebo-controlled trials. In a systematic review, aromatase inhibitors were shown to have promising results for pain relief when combined with either progestins, COCPs, or GnRH analogues. However, the authors concluded that the strength of this inference was limited due to lack of sizeable trials.

• #27

  https://www.who.int/news-room/fact-sheets/detail/endometriosis

  Most current hormonal management is not suitable for persons suffering from endometriosis who wish to get pregnant, since they affect ovulation. […] Treatment options for infertility due to endometriosis include laparoscopic surgical removal of endometriosis, ovarian stimulation with intrauterine insemination (IUI), and in vitro fertilization (IVF), but success rates vary.

• #28 Endometriosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10857-endometriosis

  Endometriosis causes tissue that is similar to the lining of the uterus to grow in other places where it doesn’t belong. Treatment for endometriosis involves medication, surgery or a combination of both. […] In many cases, your treatment plan will focus primarily on managing your pain and improving fertility issues (if you’re planning on a future pregnancy). Medication and surgery (or both) are possible treatment options. […] Medications can help manage the symptoms of endometriosis. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be helpful with pain. Hormonal therapies are another option. They can help with pain and with suppressing your menstrual cycle. […] In some cases, your provider might recommend surgery to treat endometriosis. There are always risks to a surgical procedure. But surgery for endometriosis can be an effective way to relieve pain and, in some cases, improve your fertility. The goal of surgery is to remove the endometriosis tissue.

• #29 What are the treatments for endometriosis? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatment

  Healthcare providers may suggest one of the following hormone treatments to treat pain from endometriosis: […] Pain medications may work well if pain or other symptoms are mild. These medications range from over-the-counter pain relievers to strong prescription pain relievers. […] Research shows that some surgical treatments can provide significant, although short-term, relief from endometriosis-related pain, so healthcare providers may recommend surgery to treat severe pain from endometriosis. […] It is important to understand what is planned during surgery because some procedures cannot be reversed, and others can affect a woman’s fertility. Therefore, women should discuss all available options with their healthcare providers before making final decisions about treatment. […] In most cases, healthcare providers will recommend laparoscopy to remove or vaporize the growths to also improve fertility in women who have mild or minimal endometriosis. […] If pregnancy does not occur after laparoscopic treatment, in vitro fertilization (IVF) may be the best option to improve fertility. […] Even though the use of hormones in IVF is successful in treating infertility related to endometriosis, other forms of hormone therapy are not as successful.

• #30 Treatment of endometriosis: a review with comparison of 8 guidelines | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01545-5

  Endometriosis, the presence of endometrial-like tissue outside the uterus, is a common clinical entity between women of reproductive age, with a prevalence of about 10%. Due to the variety of endometriosis-associated symptoms, a great variety of treatments have been implemented. The aim of this review is to give an overview on therapeutical approaches of eight national and international widely used guidelines. […] All the above-mentioned guidelines agree that the combined oral contraceptive pill, progestogens are therapies recommended for endometriosis associated pain. Concerning infertility, there is no clear consensus about surgical treatment. Discrepancies are also found on recommendation of the second- and third-line treatments. […] All the included guidelines recommend laparoscopic surgery in preference to laparotomy for chronic pain of endometriosis and infertility, because of less pain, shorter duration of hospitalisation, quicker recovery and better cosmetic result.

• #31 Endometriosis Treatment And Support | EndoFound

  https://www.endofound.org/endometriosis-treatment-support

  Conservative surgery is an endometriosis surgery technique that is most often performed when endometriosis lesions can be well-recognized and specifically removed, leaving healthy organ tissue intact. Only the affected tissue is removed in this approach. While there are many different techniques of conservative surgery, laparoscopic excision surgery is the gold standard of treatment for endometriosis. […] It is ideal to have surgery with minimal use of heat and electricity. Often times, surgeons will use techniques such as ablation with a laser or cauterization (energy generated from electricity) to burn off and destroy endometriosis lesions. However, this increases the chance of not fully removing the endometriosis lesions and risks damaging the surrounding healthy tissue. This does not mean that lasers and high-energy devices cannot be used during surgery, as they can often be helpful for coagulation (stopping bleeding), but they should not be used for removing lesions themselves. Ablation or cauterization only remove the tissue on the surface but neglect the tissue growing beneath the surface. In most cases, ablation/cauterization surgery will not be effective for long-term management of endometriosis because the tissue remains below the surface. Excision surgery is the gold standard for treatment.

• #32 Endometriosis Treatment And Support | EndoFound

  https://www.endofound.org/endometriosis-treatment-support

  Conservative surgery is an endometriosis surgery technique that is most often performed when endometriosis lesions can be well-recognized and specifically removed, leaving healthy organ tissue intact. Only the affected tissue is removed in this approach. While there are many different techniques of conservative surgery, laparoscopic excision surgery is the gold standard of treatment for endometriosis. […] It is ideal to have surgery with minimal use of heat and electricity. Often times, surgeons will use techniques such as ablation with a laser or cauterization (energy generated from electricity) to burn off and destroy endometriosis lesions. However, this increases the chance of not fully removing the endometriosis lesions and risks damaging the surrounding healthy tissue. This does not mean that lasers and high-energy devices cannot be used during surgery, as they can often be helpful for coagulation (stopping bleeding), but they should not be used for removing lesions themselves. Ablation or cauterization only remove the tissue on the surface but neglect the tissue growing beneath the surface. In most cases, ablation/cauterization surgery will not be effective for long-term management of endometriosis because the tissue remains below the surface. Excision surgery is the gold standard for treatment.

• #33 6 Nonhormonal Treatment for Endometriosis

  https://www.healthline.com/health/non-hormonal-treatment-for-endometriosis

  A 2018 study reported that laparoscopy for endometriosis treated pelvic pain and improved the overall quality of life for women with endometriosis. Many of the study participants were also able to stop taking other medications for endometriosis. […] Nonhormonal endometriosis treatments are available, but most may not be as effective as hormonal options. […] However, everyone responds very differently to treatments, and some nonhormonal methods may help relieve endometriosis symptoms in some people.

• #34 Treating the pain of endometriosis – Harvard Health

  https://www.health.harvard.edu/blog/treating-the-pain-of-endometriosis-2020112021458

  Lifestyle improvements. Maintaining a regular exercise program, a healthy sleep schedule, and a healthful, balanced diet can help you better cope with and manage stress related to your endometriosis. […] Surgery. Your doctor may recommend surgery to remove or destroy abnormal tissue growth, to help improve your quality of life or your chances of getting pregnant. Some studies have shown that removing growths of abnormal tissue and scar tissue caused by mild to moderate endometriosis can increase the likelihood of getting pregnant. […] Ultimately, it may take time to find the right combination of treatments to ease pain and manage this condition. But working closely with your doctor makes it more likely that you will be able to do so.

• #35 Endometriosis 101: 4 Stages & Treatment Options | CCRM Fertility

  https://www.ccrmivf.com/blog/four-stages-of-endometriosis/

  The classical therapy for endometriosis has been surgical intervention. This is typically performed in a minimally invasive manner through laparoscopy. The adhesions are removed and the lesions are either destroyed with various energy sources (e.g. cautery, laser, among others) or excised. […] The only effective treatment for ovarian cysts is surgical removal. Drainage or drug therapy is not effective in this circumstance. Very extensive stage 4 endometriosis involving the bowel and ureters (tubes that bring urine from the kidney to the bladder) requires extensive surgery that should only be performed by a highly skilled specialist in endometriosis surgery and may require the assistance of a bowel surgeon and/or urologist. For individuals who do not respond to less invasive surgery or medical therapy and whose child-bearing is complete, hysterectomy represents an ultimate option.

• #36 Endometriosis | ACOG

  https://www.acog.org/womens-health/faqs/endometriosis

  After surgery, most women have relief from pain. But there is a chance the pain will come back. Up to 8 in 10 women have pain again within 2 years of surgery. This may be due to endometriosis that was not visible or could not be removed at the time of surgery. The more severe the disease, the more likely it is to return. Taking birth control pills or other medications after having surgery may help extend the pain-free period. […] If pain is severe and does not go away after treatment, a hysterectomy may be a last resort option. Endometriosis is less likely to lead to future pain if your ovaries are removed at the time of hysterectomy. Either way, the goal of surgical treatment is to remove as much as possible of the endometriosis that is found outside the uterus.

• #37 Endometriosis Treatment And Support | EndoFound

  https://www.endofound.org/endometriosis-treatment-support

  Definitive surgery is performed when there is diffuse involvement of endometriosis to a particular site, and involves the removal of organs. The most common form of definitive endometriosis surgery is a hysterectomy (removal of the uterus). This can either include or exclude removal of the ovaries and cervix depending on the form of hysterectomy the patient and physician agree upon. As undergoing a hysterectomy is a serious decision, it is crucial that the patient and physician fully discuss the necessity for this procedure and that the patient is comfortable with their decision. […] It is a common myth that having a hysterectomy will cure endometriosis. There is no cure for endometriosis and a hysterectomy is rarely the best treatment. Most endometriosis is located in areas other than the reproductive organs. If you simply remove the uterus and do not excise the remaining lesions, patients will continue to have pain. Decisions regarding a hysterectomy should be made with a doctor experienced in treating endometriosis and should only be performed if agreed upon by the patient.

• #38

  https://www2.hse.ie/conditions/endometriosis/treatment/

  Surgery is carried out using a keyhole procedure called laparoscopy. During the surgery, the gynaecologist would either excise or ablate the endometriosis tissue. […] Any surgical procedure carries risks. Discuss these with your surgeon before undergoing treatment. […] A hysterectomy may be recommended if you continue to have symptoms and if all other suitable treatment options have not helped. Hysterectomy on its own is not the first choice of treatment for managing endometriosis. […] Hysterectomies cannot be reversed. There is no guarantee the endometriosis symptoms will not return after the operation. If the ovaries are left in place, the endometriosis is more likely to return. […] Like all types of surgery, surgery for endometriosis carries a risk of complications. If surgery is recommended for you, talk to your surgeon about the possible risks before agreeing to treatment.

• #39 Endometriosis: Causes, Complications, and Treatment

  https://www.healthline.com/health/endometriosis

  Your doctor may recommend a total hysterectomy as a last resort if your condition does not improve with other treatments. […] During a total hysterectomy, a surgeon removes the uterus and cervix. They also remove the ovaries because these organs make estrogen, and estrogen can cause the growth of endometrial-like tissue. […] Keep in mind that you may still feel pain associated with endometriosis after a hysterectomy. […] However, effective treatments, such as medications, hormone therapy, and surgery, are available to help manage its side effects and complications like pain and fertility issues.

• #40 Endometriosis | ACOG

  https://www.acog.org/womens-health/faqs/endometriosis

  After surgery, most women have relief from pain. But there is a chance the pain will come back. Up to 8 in 10 women have pain again within 2 years of surgery. This may be due to endometriosis that was not visible or could not be removed at the time of surgery. The more severe the disease, the more likely it is to return. Taking birth control pills or other medications after having surgery may help extend the pain-free period. […] If pain is severe and does not go away after treatment, a hysterectomy may be a last resort option. Endometriosis is less likely to lead to future pain if your ovaries are removed at the time of hysterectomy. Either way, the goal of surgical treatment is to remove as much as possible of the endometriosis that is found outside the uterus.

• #41

  https://www.who.int/news-room/fact-sheets/detail/endometriosis

  Most current hormonal management is not suitable for persons suffering from endometriosis who wish to get pregnant, since they affect ovulation. […] Treatment options for infertility due to endometriosis include laparoscopic surgical removal of endometriosis, ovarian stimulation with intrauterine insemination (IUI), and in vitro fertilization (IVF), but success rates vary.

• #42 Endometriosis: pathogenesis and treatment | Nature Reviews Endocrinology

  https://www.nature.com/articles/nrendo.2013.255

  Pain can be treated by excising peritoneal implants, deep nodules and ovarian cysts, or inducing lesion suppression by abolishing ovulation and menstruation through hormonal manipulation with progestins, oral contraceptives and gonadotropin-releasing hormone agonists. Medical therapy is symptomatic, not cytoreductive; surgery is associated with high recurrence rates. Although lesion eradication is considered a fertility-enhancing procedure, the benefit on reproductive performance is moderate. Assisted reproductive technologies constitute a valid alternative.

• #43 Endometriosis 101: 4 Stages & Treatment Options | CCRM Fertility

  https://www.ccrmivf.com/blog/four-stages-of-endometriosis/

  For women with endometriosis who are having difficulty conceiving, comprehensive fertility testing and a full evaluation is completed first. Potential treatment options include surgery, which is slightly beneficial for fertility or moving more aggressively to intrauterine insemination (IUI), or in vitro fertilization (IVF). […] Unfortunately, the medical treatments of symptomatic endometriosis mentioned earlier have not been shown to improve pregnancy rates except for use of certain agents just before embryo transfer in IVF, and the benefit of surgical intervention on improving pregnancy rates is controversial and depends on the specific circumstances including extent of disease and nature of the surgical technique.

• #44 Endometriosis Treatment & Management: Approach Considerations, Hormonal Therapy, Surgical Intervention

  https://emedicine.medscape.com/article/271899-treatment

  The dependence of endometriosis on the woman’s cyclic production of menstrual cycle hormones provides the basis for medical therapy. Medications currently recommended include gonadotropin-releasing hormone (GnRH) agonists, progestins, oral contraceptive pills, and androgens. Each of these interrupts the normal cyclic production of reproductive hormones. There are some data supporting the use of aromatase inhibitors for refractory or recurrent endometriosis. […] In women who wish to preserve their reproductive potential, the rates of recurrent pain symptoms are 44% with surgical management and 53% with medical management. […] Medical treatment of minimal or mild endometriosis has not been shown to increase pregnancy rates. Moderate to severe endometriosis should be treated surgically. […] Surgical ablation of asymptomatic endometriosis has also been shown to improve fecundity rates on a 3-year follow-up.

• #45 What are the treatments for endometriosis? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatment

  Healthcare providers may suggest one of the following hormone treatments to treat pain from endometriosis: […] Pain medications may work well if pain or other symptoms are mild. These medications range from over-the-counter pain relievers to strong prescription pain relievers. […] Research shows that some surgical treatments can provide significant, although short-term, relief from endometriosis-related pain, so healthcare providers may recommend surgery to treat severe pain from endometriosis. […] It is important to understand what is planned during surgery because some procedures cannot be reversed, and others can affect a woman’s fertility. Therefore, women should discuss all available options with their healthcare providers before making final decisions about treatment. […] In most cases, healthcare providers will recommend laparoscopy to remove or vaporize the growths to also improve fertility in women who have mild or minimal endometriosis. […] If pregnancy does not occur after laparoscopic treatment, in vitro fertilization (IVF) may be the best option to improve fertility. […] Even though the use of hormones in IVF is successful in treating infertility related to endometriosis, other forms of hormone therapy are not as successful.

• #46 Endometriosis – Wikipedia

  https://en.wikipedia.org/wiki/Endometriosis

  Treatment for endometriosis often includes hormonal therapies, pain management, and in some cases, surgery to remove the endometrial tissue. For women who struggle with infertility due to endometriosis, assisted reproductive technologies such as in vitro fertilization (IVF) may be recommended, sometimes in combination with surgical treatment to improve fertility outcomes.

• #47 What are the treatments for endometriosis? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatment

  Healthcare providers may suggest one of the following hormone treatments to treat pain from endometriosis: […] Pain medications may work well if pain or other symptoms are mild. These medications range from over-the-counter pain relievers to strong prescription pain relievers. […] Research shows that some surgical treatments can provide significant, although short-term, relief from endometriosis-related pain, so healthcare providers may recommend surgery to treat severe pain from endometriosis. […] It is important to understand what is planned during surgery because some procedures cannot be reversed, and others can affect a woman’s fertility. Therefore, women should discuss all available options with their healthcare providers before making final decisions about treatment. […] In most cases, healthcare providers will recommend laparoscopy to remove or vaporize the growths to also improve fertility in women who have mild or minimal endometriosis. […] If pregnancy does not occur after laparoscopic treatment, in vitro fertilization (IVF) may be the best option to improve fertility. […] Even though the use of hormones in IVF is successful in treating infertility related to endometriosis, other forms of hormone therapy are not as successful.

• #48 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. […] Acupuncture is an alternative approach to pain management and relaxation, acupuncture has gained wide popularity. […] Life style modification, physical therapy and massage can help endometriosis patients successfully manage pain. […] Biofeedback teaches patients to alter their response to pain signals by controlling their heart rate, respirations, muscle tone and temperature. […] Transcutaneous electrical nerve (TEN) stimulation is the direct electrical stimulation of the skin overlying pain trigger-points to provide relief. […] Osteopathic treatment manages the patient with a holistic pain care plan that includes manipulation of muscles, ligaments and skeletal alignment in conjunction with analgesic and anti-inflammatory medication.

• #49 Treating the pain of endometriosis – Harvard Health

  https://www.health.harvard.edu/blog/treating-the-pain-of-endometriosis-2020112021458

  Acupuncture. This is an alternative medicine treatment, which uses small needles applied at specific sites on the body to relieve chronic pain. […] Pelvic floor physical therapy. This practice addresses problems with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. […] Cognitive behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have looked at the effects of CBT on endometriosis symptoms, it has been used to successfully manage other conditions that cause chronic pain. […] Stress management. Experiencing chronic pain can cause stress, which may heighten sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important component of endometriosis management.

• #50 Management Options | The Endometriosis Network Canada

  https://endometriosisnetwork.com/management-options/

  Sometimes, pain comes back months or years after endometriosis surgery. […] The chance of endometriosis coming back after surgery depends on where the endometriosis was located and the type of surgery you had. […] Medication options can be used to treat the symptoms of endometriosis. […] Other medications used to manage the symptoms of endometriosis include those that affect the body’s hormones and control or stop the menstrual cycle. […] Medication options for endometriosis vary in how effective they are in managing symptoms. […] Speak to your doctor about the different side effects and risks of these medications. […] Many people with endometriosis benefit from other types of medical care not provided by gynecologists. […] Pelvic health physiotherapy: an effective treatment for some symptoms of endometriosis, like pain with sexual activity. […] People with endometriosis often try Complementary and Alternative Medicine (CAM) alongside traditional medical approaches. […] CAM options used by people with endometriosis can include: Acupuncture, Cannabis, Diet/nutrition, Exercise, Heat, Meditation / breathing / relaxation practices.

• #51 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. […] Acupuncture is an alternative approach to pain management and relaxation, acupuncture has gained wide popularity. […] Life style modification, physical therapy and massage can help endometriosis patients successfully manage pain. […] Biofeedback teaches patients to alter their response to pain signals by controlling their heart rate, respirations, muscle tone and temperature. […] Transcutaneous electrical nerve (TEN) stimulation is the direct electrical stimulation of the skin overlying pain trigger-points to provide relief. […] Osteopathic treatment manages the patient with a holistic pain care plan that includes manipulation of muscles, ligaments and skeletal alignment in conjunction with analgesic and anti-inflammatory medication.

• #52 12 Natural Endometriosis Treatments

  https://www.verywellhealth.com/natural-treatments-for-endometriosis-89275

  One 2019 study published in the International Journal of Fertility and Sterility found that eight weeks of probiotic supplementation with lactobacillus capsules provided some beneficial effects for endometriosis-related pain. […] Several small studies have reported that resveratrol supplements can help reduce pelvic pain and cramps associated with endometriosis. Doses of 30 milligrams (mg) per day reduced pain scores during and between periods by 82%. […] A 2017 review of studies published in PLoS One found that acupuncture may help ease pelvic and abdominal pain in women with endometriosis. […] A systematic review and meta-analysis published in 2018 also found that among the approaches studied, only acupuncture notably reduced pain. […] A review of studies published in the Cochrane Database of Systematic Reviews found that Chinese herbs fared well when compared to two prescription drugs commonly used to treat endometriosis, Dimetrose (gestrinone) and Danocrine (danazol).

• #53 Home remedies for endometriosis: 9 ways to treat symptoms

  https://www.medicalnewstoday.com/articles/321402

  Endometriosis can cause painful periods, cramps, and heavy menstrual bleeding. Home remedies may help ease endometriosis pain by controlling inflammation, relaxing the muscles, and improving overall health. […] While there is no cure for this condition, some treatments and home remedies can relieve the pain and discomfort. […] A person might find that the following techniques help reduce the pain and other symptoms of endometriosis. […] Pain medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve) are examples of nonsteroidal anti-inflammatory drugs (NSAIDs) that are available over the counter. NSAIDs can help reduce inflammation, which may relieve cramping and pain. […] Altering the diet may reduce endometriosis symptoms, though identifying the most effective changes requires more research.

• #54 Home remedies for endometriosis: 9 ways to treat symptoms

  https://www.medicalnewstoday.com/articles/321402

  There is some evidence that a gluten-free diet may help reduce pain associated with endometriosis. […] Certain herbal supplements might help reduce endometriosis symptoms. […] While it cannot cure endometriosis, turmeric, for example, has anti-inflammatory properties. […] Some research has suggested that omega-3 fatty acids may help prevent the tissue that characterizes endometriosis from forming. […] CBD oil may help ease pain associated with endometriosis. […] Regular exercise helps release endorphins. These feel good hormones can help reduce pain. […] People with endometriosis may benefit from medical treatments to reduce pain and other symptoms. […] Treatments for endometriosis that a doctor may recommend include: hormone therapy, such as hormonal birth control, surgical treatments, pain medications, such as prescription NSAIDs.

• #55 Treating the pain of endometriosis – Harvard Health

  https://www.health.harvard.edu/blog/treating-the-pain-of-endometriosis-2020112021458

  Acupuncture. This is an alternative medicine treatment, which uses small needles applied at specific sites on the body to relieve chronic pain. […] Pelvic floor physical therapy. This practice addresses problems with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. […] Cognitive behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have looked at the effects of CBT on endometriosis symptoms, it has been used to successfully manage other conditions that cause chronic pain. […] Stress management. Experiencing chronic pain can cause stress, which may heighten sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important component of endometriosis management.

• #56 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. […] Acupuncture is an alternative approach to pain management and relaxation, acupuncture has gained wide popularity. […] Life style modification, physical therapy and massage can help endometriosis patients successfully manage pain. […] Biofeedback teaches patients to alter their response to pain signals by controlling their heart rate, respirations, muscle tone and temperature. […] Transcutaneous electrical nerve (TEN) stimulation is the direct electrical stimulation of the skin overlying pain trigger-points to provide relief. […] Osteopathic treatment manages the patient with a holistic pain care plan that includes manipulation of muscles, ligaments and skeletal alignment in conjunction with analgesic and anti-inflammatory medication.

• #57 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. […] Acupuncture is an alternative approach to pain management and relaxation, acupuncture has gained wide popularity. […] Life style modification, physical therapy and massage can help endometriosis patients successfully manage pain. […] Biofeedback teaches patients to alter their response to pain signals by controlling their heart rate, respirations, muscle tone and temperature. […] Transcutaneous electrical nerve (TEN) stimulation is the direct electrical stimulation of the skin overlying pain trigger-points to provide relief. […] Osteopathic treatment manages the patient with a holistic pain care plan that includes manipulation of muscles, ligaments and skeletal alignment in conjunction with analgesic and anti-inflammatory medication.

• #58 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. […] Acupuncture is an alternative approach to pain management and relaxation, acupuncture has gained wide popularity. […] Life style modification, physical therapy and massage can help endometriosis patients successfully manage pain. […] Biofeedback teaches patients to alter their response to pain signals by controlling their heart rate, respirations, muscle tone and temperature. […] Transcutaneous electrical nerve (TEN) stimulation is the direct electrical stimulation of the skin overlying pain trigger-points to provide relief. […] Osteopathic treatment manages the patient with a holistic pain care plan that includes manipulation of muscles, ligaments and skeletal alignment in conjunction with analgesic and anti-inflammatory medication.

• #59 Treating the pain of endometriosis – Harvard Health

  https://www.health.harvard.edu/blog/treating-the-pain-of-endometriosis-2020112021458

  Acupuncture. This is an alternative medicine treatment, which uses small needles applied at specific sites on the body to relieve chronic pain. […] Pelvic floor physical therapy. This practice addresses problems with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. […] Cognitive behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have looked at the effects of CBT on endometriosis symptoms, it has been used to successfully manage other conditions that cause chronic pain. […] Stress management. Experiencing chronic pain can cause stress, which may heighten sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important component of endometriosis management.

• #60 Endometriosis Treatment, Therapy, and Surgery Options

  https://www.everydayhealth.com/endometriosis/guide/treatment/

  Laparoscopic surgery removes endometriosis lesions through excision. […] Hysterectomy is recommended less frequently as surgical treatment. […] Endometriosis is a chronic condition that will recur unless the menstrual cycle is stopped. […] After surgery, we commonly suppress recurrent endometriosis by starting continuous birth control pills. This is safe and effective. […] Some supplements may interfere with medication you are taking (especially if you are on blood thinners), so run it by your physician before taking anything new. […] Combine 1,000 milligrams (mg) of vitamin C and 1,200 international units (IU) of vitamin E daily to reduce aches and pains. […] Caution: If you do decide to try alternative remedies, discuss your choices ahead of time with your physician. […] Do not forgo your traditional therapy for an alternative route.

• #61 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  The most effective approach to chronic pain management associated with endometriosis combines traditional medical and surgical treatment(s) with complementary therapies provided by a multidisciplinary team. […] Acupuncture is an alternative approach to pain management and relaxation, acupuncture has gained wide popularity. […] Life style modification, physical therapy and massage can help endometriosis patients successfully manage pain. […] Biofeedback teaches patients to alter their response to pain signals by controlling their heart rate, respirations, muscle tone and temperature. […] Transcutaneous electrical nerve (TEN) stimulation is the direct electrical stimulation of the skin overlying pain trigger-points to provide relief. […] Osteopathic treatment manages the patient with a holistic pain care plan that includes manipulation of muscles, ligaments and skeletal alignment in conjunction with analgesic and anti-inflammatory medication.

• #62 Endometriosis Therapies – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/complimentary-and-alternative-therapies-for-endometriosis

  Herbal Medicine and Dietary modification includes: Chinese herbs, homeopathy, ayurvedic medicine and naturopathy. […] Ultimately under the guidance of a patients primary gynecologist, successful management of some of the often debilitating symptoms of endometriosis may be achieved by the combined effort of a multidisciplinary healthcare team that includes alternative therapies.

• #63 What are the treatment options? – Endometriosis Cymru

  https://endometriosis.cymru/diagnosis-treatment-and-care/what-are-the-treatment-options/

  Currently there is no cure for endometriosis but a range of treatments are available to help manage the symptoms and reduce the impact of the disease on a persons life. […] Endometriosis treatments fall into three categories painkillers, hormonal treatments and surgery. […] The treatments received will depend on the severity of a persons symptoms, their personal circumstances and preferences, and any other physical or mental health conditions they may have. […] A doctor may offer medicine that acts on hormone levels to slow the growth of endometriosis. […] Many hormone treatments are designed to directly reduce the amount of oestrogen in the body. […] Hormonal medicine can slow the worsening of endometriosis disease but it will not stop it entirely or cure disease that already exists. […] In these cases surgery might be considered to treat the disease.

• #64 Endometriosis Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/womens-health/obgyn/gynecology/endometriosis/treatments

  Treatment options include medicine, surgery or both. Whether you hope to become pregnant will play a role in your options. If symptoms are mild, you may only need pain medicine. In other cases, hormone-based medicine, such as birth control pills, will stop ovulation and slow endometriosis. […] Several surgical options can be used to remove the implants. In some cases, physicians may be able to remove the growths through laparoscopy. In other cases, open surgery is needed. Removal of the uterus may also be necessary for some women. […] Endometriosis can make it very hard or impossible for a woman to get pregnant. Sometimes surgery can help. But, in a few cases, women may remain infertile. […] Serdar E. Bulun, MD, is a world-renowned specialist in the use of aromatase inhibitors to treat women with endometriosis. Dr. Bulun is joined by a multidisciplinary team at the Womens Health Center housed under Prentice Womens Hospital at Northwestern Memorial Hospital. Their team offers leading-edge diagnostic testing as well as personalized treatment plans for women with endometriosis and pelvic pain. […] For complex conditions, such as uterine fibroids or endometriosis, the Northwestern Medicine Center for Complex Gynecology offers telehealth appointments for Illinois patients. This enables you to access world-class care from a convenient location.

• #65 Endometriosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661

  Hormone therapy isn’t a permanent fix for endometriosis. The symptoms could come back after you stop treatment. […] Conservative surgery removes endometriosis tissue. It aims to preserve the uterus and the ovaries. If you have endometriosis and you’re trying to become pregnant, this type of surgery may boost your chances of success. […] Endometriosis can lead to trouble getting pregnant. If you have a hard time conceiving, your health care team may recommend fertility treatment. […] Hysterectomy is surgery to remove the uterus. Taking out the uterus and ovaries was once thought to be the most effective treatment for endometriosis. Today, some experts consider it to be a last resort to ease pain when other treatments haven’t worked. […] To manage and treat endometriosis, it’s key to find a health care professional with whom you feel comfortable. You may want to get a second opinion before you start any treatment. That way, you can be sure you know all of your options and the pros and cons of each.

• #66 Management and treatment of endometriosis | Jean Hailes… | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/endometriosis/management-treatment

  When endometriosis is acknowledged and treated, most women with the condition do well. Your doctor can help coordinate a team of experienced health professionals to provide quality care. Your team may include a gynaecologist, specialist surgeon and pelvic floor physiotherapist. […] On this page we explain different treatments for endometriosis, including hormone and non-hormone medicines, non-drug treatments, natural therapies and surgery. […] Your doctor may recommend pain-relief medicines, such as paracetamol and non-steroidal anti-inflammatory drugs, for example, ibuprofen for temporary relief. […] Hormone medicines for endometriosis include the Pill, progestogens and gonadotrophin-releasing hormone analogues (GnRHa). […] Hormone medicines may reduce the pain and severity of the endometriosis by suppressing the growth of endometrial cells and stopping any bleeding. But symptoms can return if you stop the treatment.

• #67 Endometriosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10857-endometriosis

  Endometriosis is a chronic disease. Many people experience relief from endometriosis pain after surgery, but the symptoms may return within a few years. The severity of your endometriosis could play a part in how quickly if at all it comes back after surgery. Your provider might suggest combining a surgical procedure with medications for the best outcome. […] With treatment, many people find relief from the symptoms of endometriosis.

• #68 Endometriosis | ACOG

  https://www.acog.org/womens-health/faqs/endometriosis

  After surgery, most women have relief from pain. But there is a chance the pain will come back. Up to 8 in 10 women have pain again within 2 years of surgery. This may be due to endometriosis that was not visible or could not be removed at the time of surgery. The more severe the disease, the more likely it is to return. Taking birth control pills or other medications after having surgery may help extend the pain-free period. […] If pain is severe and does not go away after treatment, a hysterectomy may be a last resort option. Endometriosis is less likely to lead to future pain if your ovaries are removed at the time of hysterectomy. Either way, the goal of surgical treatment is to remove as much as possible of the endometriosis that is found outside the uterus.

• #69 Endometriosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10857-endometriosis

  Endometriosis is a chronic disease. Many people experience relief from endometriosis pain after surgery, but the symptoms may return within a few years. The severity of your endometriosis could play a part in how quickly if at all it comes back after surgery. Your provider might suggest combining a surgical procedure with medications for the best outcome. […] With treatment, many people find relief from the symptoms of endometriosis.

• #70

  https://www2.hse.ie/conditions/endometriosis/treatment/

  There is currently no cure for endometriosis and it can be difficult to treat. There are treatments that can help ease and manage the symptoms of endometriosis and slow down the progression of the disease. […] Treatment can be given to: relieve pain, slow the growth of endometriosis tissue, improve fertility, reduce the likelihood of the condition returning. […] Treatments include: painkillers and anti-inflammatories ibuprofen, paracetamol hormone medicines, contraceptives such as the oral contraceptive pill, surgery to remove patches of endometriosis tissue, often by keyhole surgery. […] In extreme cases, you may need an operation to remove the endometriosis tissue on the affected organs. Most women with endometriosis will not need an operation to manage their symptoms. Your doctor will discuss the best options with you for your situation.

• #71 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Endometriosis-Breakthroughs-New-Treatments-and-Research.aspx

  Endometriosis is a chronic estrogen-dependent inflammatory disease that affects approximately 10% of reproductive-age women worldwide, leading to symptoms such as pelvic pain, infertility, and organ dysfunction. Despite its significant impact on health and quality of life, treatment options remained limited, often requiring surgical intervention or long-term hormone therapy with variable efficacy and side effects. However, recent advancements in endometriosis research are reshaping our understanding of the disease, offering novel therapeutic approaches that range from pharmacological interventions to regenerative medicine and microbiome-based therapies. These breakthroughs not only aim to manage symptoms but also address the root causes of endometriosis, with a focus on inflammation, immune dysregulation, and tissue remodeling. Hormonal therapy remains the mainstay of non-surgical treatment for endometriosis. Recent studies have explored new pharmacological agents targeting estrogen synthesis, inflammation, and immune modulation. Among these, gonadotropin-releasing hormone (GnRH) antagonists, such as elagolix, have demonstrated promising results by effectively reducing pain symptoms while minimizing estrogen deprivation-related side effects. Another promising development is the use of aromatase inhibitors, which inhibit local estrogen production within endometriotic lesions. Off-label aromatase inhibitors such as letrozole have shown efficacy in reducing lesion size and pain severity, particularly in cases resistant to conventional hormonal therapies. Additionally, selective estrogen receptor modulators (SERMs) have also been investigated for their ability to modulate estrogen activity while preserving bone health, a common concern with long-term hormonal therapies. Immunomodulatory therapies are also gaining attention, given the role of immune dysregulation in endometriosis pathophysiology. Anti-tumor necrosis factor- (TNF-) agents and regulatory T-cell therapies are being investigated for their potential to modulate inflammatory pathways associated with endometriosis progression. Furthermore, recent findings suggest that progesterone plays a crucial anti-inflammatory role in endometriosis management, as it modulates immune responses and reduces inflammation through specific molecular pathways. Surgical excision remains a critical intervention for advanced endometriosis, particularly in cases of deep infiltrating endometriosis. Advances in minimally invasive techniques, including robotic-assisted laparoscopic surgery, have improved precision and outcomes for patients requiring excision of extensive lesions. Regenerative medicine is emerging as a potential game-changer in endometriosis treatment. Stem cell therapy is being extensively explored for its ability to repair endometrial tissue damage, restore fertility, and alleviate chronic pain. Recent studies suggest that menstrual blood-derived stem cells and mesenchymal stem cells possess immunomodulatory properties and the ability to regenerate functional endometrial tissue. Additionally, tissue engineering approaches, including bioengineered endometrial grafts, are under investigation as potential alternatives to traditional hormone therapies and surgical interventions. Personalized medicine is becoming increasingly relevant in endometriosis management, with extensive research focusing on genetic and molecular biomarkers to guide individualized treatment strategies. Advances in genomic studies have identified estrogen receptor (ER) subtypes, particularly ER, as potential therapeutic targets in endometriosis. Future research should focus on translating these discoveries into clinical practice, ensuring that innovative treatments reach those who need them most.

• #72 Could Gene and Cell Therapy be the Future of Endometriosis Treatment?

  https://www.asgct.org/research/news/march-2020/could-cell-and-gene-therapy-be-the-future-of-endom

  Advances in gene and cell therapies are rapidly evolving, so we also want to look into the great potential these therapies may have in the battle against endometriosis. […] There currently is no cure for endometriosis, but several measures can be taken to circumvent the symptoms as much as possible. […] Encouragingly, there is a strong research community focused on developing new treatments for endometriosis. […] Gene and cell therapies are an exciting option with great potential to explore and develop personalized medicine for the treatment of endometriosis. […] Gene and RNA based therapies are the future of endometriosis treatment. […] Therefore, I predict that cell-based therapies will play a major role in the effective treatment modalities of endometriosis developed in the future. […] Gene and cell therapy offers hope in this regard, given the complex architecture and genetic construction of this disease.

• #73 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Endometriosis-Breakthroughs-New-Treatments-and-Research.aspx

  Endometriosis is a chronic estrogen-dependent inflammatory disease that affects approximately 10% of reproductive-age women worldwide, leading to symptoms such as pelvic pain, infertility, and organ dysfunction. Despite its significant impact on health and quality of life, treatment options remained limited, often requiring surgical intervention or long-term hormone therapy with variable efficacy and side effects. However, recent advancements in endometriosis research are reshaping our understanding of the disease, offering novel therapeutic approaches that range from pharmacological interventions to regenerative medicine and microbiome-based therapies. These breakthroughs not only aim to manage symptoms but also address the root causes of endometriosis, with a focus on inflammation, immune dysregulation, and tissue remodeling. Hormonal therapy remains the mainstay of non-surgical treatment for endometriosis. Recent studies have explored new pharmacological agents targeting estrogen synthesis, inflammation, and immune modulation. Among these, gonadotropin-releasing hormone (GnRH) antagonists, such as elagolix, have demonstrated promising results by effectively reducing pain symptoms while minimizing estrogen deprivation-related side effects. Another promising development is the use of aromatase inhibitors, which inhibit local estrogen production within endometriotic lesions. Off-label aromatase inhibitors such as letrozole have shown efficacy in reducing lesion size and pain severity, particularly in cases resistant to conventional hormonal therapies. Additionally, selective estrogen receptor modulators (SERMs) have also been investigated for their ability to modulate estrogen activity while preserving bone health, a common concern with long-term hormonal therapies. Immunomodulatory therapies are also gaining attention, given the role of immune dysregulation in endometriosis pathophysiology. Anti-tumor necrosis factor- (TNF-) agents and regulatory T-cell therapies are being investigated for their potential to modulate inflammatory pathways associated with endometriosis progression. Furthermore, recent findings suggest that progesterone plays a crucial anti-inflammatory role in endometriosis management, as it modulates immune responses and reduces inflammation through specific molecular pathways. Surgical excision remains a critical intervention for advanced endometriosis, particularly in cases of deep infiltrating endometriosis. Advances in minimally invasive techniques, including robotic-assisted laparoscopic surgery, have improved precision and outcomes for patients requiring excision of extensive lesions. Regenerative medicine is emerging as a potential game-changer in endometriosis treatment. Stem cell therapy is being extensively explored for its ability to repair endometrial tissue damage, restore fertility, and alleviate chronic pain. Recent studies suggest that menstrual blood-derived stem cells and mesenchymal stem cells possess immunomodulatory properties and the ability to regenerate functional endometrial tissue. Additionally, tissue engineering approaches, including bioengineered endometrial grafts, are under investigation as potential alternatives to traditional hormone therapies and surgical interventions. Personalized medicine is becoming increasingly relevant in endometriosis management, with extensive research focusing on genetic and molecular biomarkers to guide individualized treatment strategies. Advances in genomic studies have identified estrogen receptor (ER) subtypes, particularly ER, as potential therapeutic targets in endometriosis. Future research should focus on translating these discoveries into clinical practice, ensuring that innovative treatments reach those who need them most.

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