Endometriosis Health Center

Understanding Endometriosis -- Diagnosis and Treatment

How Do I Know If I Have Endometriosis?

Your doctor will ask you questions and do a pelvic exam. But your doctor won't know for sure that it's endometriosis until a surgeon can examine your body internally. 

The most common procedure is called laparoscopy. During this surgery a thin, lighted tube is inserted into the abdomen through a small incision. 

Women are usually unconscious when it's done. Many doctors remove a small piece of tissue and test it to confirm the diagnosis of endometriosis.

What Are the Treatments for Endometriosis?

There are three ways to treat endometriosis: watchful waiting, hormone treatments, and surgery. The choice depends on a number of factors including the woman's symptoms, her age, whether fertility is a factor, and the severity of the disease. Menopause usually ends the symptoms, but in women who take estrogen during and after menopause, symptoms may continue.

In watchful waiting, nothing is done. Instead, your doctor regularly checks on your health and symptoms to see if they get worse. Watchful waiting is a good option for women with mild disease who want to bear children, and women approaching menopause. For women who can conceive and want to have a child, pregnancy may alleviate symptoms, probably because it temporarily stops menstrual cycles. In some women, endometriosis symptoms do not return after they have given birth. 

As a hormone treatment, your doctor may have you take birth control pills continuously for nine months or more. This treatment can be effective, but in many cases symptoms return after you stop taking the pill.

If birth control pills don't help, your doctor may try other hormone treatments. Two of them are medroxyprogesterone (Provera) and gonadotropin-releasing hormone agonists (Lupron, Synarel, and Zoladex). Two others are danazol and gestrinone, which are made from male hormones. 

Unfortunately, hormone treatments have side effects  such as weight gain, depression, acne, increased body hair, and irregular bleeding. Also, if you stop taking them, your symptoms may come back.

Pain medications such as ibuprofen and naproxen may help the cramps but will not get rid of the endometriosis tissue that is causing the cramps

If drugs don't help, your doctor may suggest surgery. There are two options: surgery to remove the endometrial tissue growing outside the uterus, or a hysterectomy. If all the tissue outside the uterus is removed, your symptoms should disappear. However, some tissue pieces may remain and regrow and your symptoms may come back, even after a hysterectomy. Your doctor may want to combine surgery with medication.

Since endometriosis often comes back and may cause pain and infertility, you may wish to join an endometriosis support group to help with coping. Many hospitals can refer you to a local support group. 

At-Home Treatments for Endometriosis

The following may help ease symptoms of endometriosis:

• Take medication such as ibuprofen or naproxen for pain relief.
• Apply a heating pad or moist heat to your pelvic area. 
• Drink warm beverages to help relax cramping muscles.
• Exercise moderately to increase endorphins, your body's natural painkillers.