How to Treat Endometriosis

Endometriosis is a syndrome in which the tissues that line the uterus develop in other parts of the body. This abnormal growth can cause pain, atypical bleeding, and even sterility. Although these growths in tissue, referred to as Endometrial implants, can occur in different parts of the body, they are generally seen in and around the pelvic region. While the cause of this disease is unknown, there are several steps you can take towards treatment, including seeking medical intervention and making diet changes.

Method 1

Method 1 of 3:

Considering Hormonal Therapy and Surgery

1
Ask your doctor about hormonal therapy. Hormonal therapy can help in the treatment of endometriosis because it is these hormones that cause the lesions to undergo changes similar to the menstrual cycle.^{[1]XResearch sourceHarada T, Momoeda M, Taketani Y, Hoshiai H, Terakawa N (November 2008). "Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: a placebo-controlled, double-blind, randomized trial". Fertility and Sterility 90 (5): 1583–8.}
- One of the most common forms of hormonal therapy is oral contraceptives; you take the pills for 21 days and then take sugar pills for 7 days to mimic the natural menstrual cycle. If the sugar pills are not taken, birth control pills stops the menstrual period completely, this helps in decreasing the pain and in some cases causes it to vanish completely.
- There are a few type of birth control pills that have only a couple days of sugar pills every 3 months; these also help reduce or eliminate pain.
2
Take progestin. This can be taken in different forms like a pill, via an injection, or through an intrauterine device (IUD). Progestin, like norethisterone, is similar to the body's hormone progesterone.^{[2]XResearch sourceP, Ezcurra D, Howles CM (2011). "Contemporary genetic technologies and female reproduction". Hum. Reprod. Update 17 (6): 829–47.doi:10.1093/humupd/dmr033.}
- When progestin is taken, it makes the progesterone levels in the body similar to what they would be if you were pregnant.
- Progestin helps in reducing estrogen production, thereby stopping ovulation, along with menstrual cycle in most users.
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3
Consider which form of progestin to use. Your options include the following:
- Pill: When taken as a pill daily, these hormones decrease menstrual flow without causing the uterus lining to grow. Once you stop taking the progestin pill, you are back to square one; the symptoms can return and pregnancy can occur.
- IUD. An IUD containing progestin, such as Mirena, helps in reducing endometriosis-related pain. It decreases the size of lesions and menstrual flow.
- Injection. As an injection, progestin has to be taken once every 3 months. This treatment generally stops the menstrual flow, but some people do bleed many times during the first year of taking the injection. When this bleeding occurs, pain can recur. After stopping the injections, it can take few months for menses to return. Once your periods are back, you can conceive.
4
Get a prescription for gonadotropin-releasing hormone (GnRH) agonists . These medications stop the production of certain hormones to prevent ovulation, menstruation, and the growth of endometriosis. This treatment sends the body into a "menopausal" state. These medicines are available in different generic names.^{[3]XTrustworthy SourceNatureRespected Multidisciplinary Scientific JournalGo to source} Their doses are as follows:
- Leuprolide is injected into muscle (intramuscularly) once a month. You can also take an injection that lasts for 3 months.
- Nafarelin is sprayed into the nose (intranasally) twice a day.
- Goserelin 3.6 mg pellet is injected under the skin of the abdomen (subcutaneously) once every 28 days. Slowly the pellet is assimilated by your body.
5
Ask your doctor about danazol. Danazol is a suppressive drug with some androgenic activity. The treatment with this drug stops the release of hormones that are involved in the menstrual cycle. You will have a period only now and then or sometimes not at all when on this medication.^{[4]XResearch source Wellbery C (1999). "Diagnosis and treatment of endometriosis". Am Fam Physician 60 (6): 1753–62, 1767–8.}
- The patient is started with the dose of 800 mg, administered in two divided doses depending on the severity of the disease.^{[5]XResearch source Wellbery C (1999). "Diagnosis and treatment of endometriosis". Am Fam Physician 60 (6): 1753–62, 1767–8.}
- For mild cases, an initial daily dose of 200 mg to 400 mg given in two divided doses is recommended and may be adjusted depending on patient response.
6
Consider the possibility of surgical treatment. Conservative surgical treatment involves removal of the tissues, adhesions and restoring the normal pelvic anatomy as far as possible.
- In order to do this the physician can perform a laparoscopy (camera assisted video surgery) so as to remove the lesions or destroy them using intense heat without harming the normal tissues. It is a minimally invasive procedure in which the surgeon makes only 2-3 small incisions on the abdomen.
- He or she can also do laparotomy which is a major operation during which the small lesions that are not visible in laparoscopy are removed, and if needed, the surgeon removes the uterus. The physician tries to conserve the ovaries as far as possible but if necessary he can remove them also. This major surgery is the last resort for endometriosis treatment.
The recurrence rate is estimated to be 10 percent per year. In patients who have had a hysterectomy where both ovaries have not been removed, there is 6 times the risk of recurrence as compared to cases in which the ovaries are removed.
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Method 2

Method 2 of 3:

Using Diet and Natural Remedies

1
Reduce your chemical intake by limiting your intake of animal fat. Different studies reveal that chronic exposure to environmental chemicals like dioxins can be a cause of endometriosis. Dioxins along with polychlorinated biphenyls (PCBs) are associated with an increased prevalence and severity of endometriosis.
- The intake of these chemicals can be reduced by decreasing your consumption of animal fat, mainly high-fat dairy, red meat, and fish. Dioxin and PCBs both get collected in animal fat and it is through them that you ingest it.
2
Eat more vegetables. Data supports the fact that flavones, a group of plant chemicals, can inhibit aromatase, an enzyme that converts androgens to estrogens.^{[6]XResearch source7Li F, Ye L, Lin SM, Leung LK. Dietary flavones and flavonones display differential effects on aromatase (CYP19) transcription in the breast cancer cells MCF-7. Mol Cell Endocrinol. 2011 Sep 15;344(1-2):51-8.}
- Celery, parsley and capsicum pepper are good sources of flavones.
- Dietary indoles also help in regulating the estrogen metabolism in the body. Vegetables like broccoli, cauliflower, cabbage, kale, Brussels sprouts, and bok choy are good sources of indole.
3
Eat more flaxseeds. Flaxseeds are high in lignans and fiber. Lignans are good in estrogen-related conditions because the bacteria in your gut converts them into metabolites that produce a weak estrogenic effect (meaning they can help to regulate estrogen-related conditions like endometriosis).
- You should eat 3 to 4 tablespoons of unrefined flax seed every day to maintain healthy blood levels of enterolactone. Other sources of lignans are whole grains, sesame seeds, sunflower seeds, cashews, kale, broccoli and berries.
4
Introduce more omega-3 fatty acids to your diet. Studies have found that omega-3 fatty acids may be beneficial for people with endometriosis as the fish oil contains two specific compounds, EPA and DHA, that can relieve pain by decreasing levels of an inflammatory chemical called prostaglandin E2.^{[7]XResearch sourceLiu Y, Chen LY, Sokolowska M, Eberlein M, Alsaaty S, Martinez-Anton A, Logun C, Qi HY, Shelhamer JH. The fish oil ingredient, docosahexaenoic acid, activates cytosolic phospholipase A2 via GPR120 receptor to produce prostaglandin E2 and plays an anti-inflammatory role in macrophages. Immunology. 2014 Sep;143(1):81-95.}
- Omega-3 fatty acids are found in fish such as salmon, mackerel, sardines, and anchovies.
5
Take magnesium supplements. Magnesium is a mineral that is believed to ease cramping caused by menstruation. It also helps in preserving water levels in the gut and can help combat constipation.
- The daily recommended dosage is 600 mg. Foods rich in magnesium are spices, cocoa, nuts, tea, cereals and vegetables like green leafy vegetables.
6
Boost your calcium intake. Calcium levels in menstruating people decrease 10 to 14 days before the onset of menses. Deficiency can cause muscle cramps, headache or pelvic pain. The recommended daily intake is 1200 mg.^{[8]XResearch source}
- Calcium can be found abundantly in milk, curd, cheese, butter, egg, amaranth, and other dairy products.
7
Eat more vitamin-C rich foods. Vitamin C is well known for helping to boost the immune system and help provide resistance to disease. It helps in building and maintaining collagen in the body. It is important that your immune system is functioning properly so that your body can combat endometrial patches that form.^{[9]XResearch source}
- The recommended dosage of Vitamin C is 1000 to 4000 mg^{[10]XTrustworthy SourceOregon State University Linus Pauling InstituteResearch center dedicated to promoting optimal health through cutting-edge nutrition research and public outreachGo to source} and can be procured by consuming citrus fruits, lemon, papaya etc.
8
Increase your vitamin E intake. Vitamin E plays an important role as it strengthens the immune system and reduces inflammation due to its antioxidant nature. It is also thought to be able to relieve menstrual cramps.^{[11]XResearch source}
- The recommended dosage is 800 IU. Almonds, avocados, etc are rich in vitamin E.
- Selenium when taken along with vitamin E helps in reducing inflammation associated with Endometriosis, and is also an immune system booster. Dosage is 400 mg.^{[12]XResearch source}
9
Experiment with an herb called goldenseal. It is herb that may have anti-biotic, anti-inflammatory, astringent and immune stimulating properties. Goldenseal contains calcium, iron, manganese, vitamin A, vitamin C, vitamin E, B-complex, and other nutrients and minerals.
- The astringent quality may help in cases of excessive menses and internal bleeding.
- It can be taken as a tincture about 2-4 ml or 0.5-1 gm decoction made by boiling goldenseal.^{[13]XResearch source}
10
Try an herbal remedy made from cramp bark. As its name implies, cramp bark may be useful in easing uterine cramps. Being a muscle relaxant, it is effective on other organs, like the intestines and the skeletal muscles.^{[14]XResearch sourceBulletti C, Coccia ME, Battistoni S,}
- For dysmenorrhea (painful menstruation), cramp bark may work most efficiently when taken regularly. Begin with 1/2 dropperfuls every half hour till some effect is seen, then every one to three hours. Decrease the dosage as symptoms wane.^{[15]XResearch sourceBulletti C, Coccia ME, Battistoni S,}
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Method 3

Method 3 of 3:

Understanding the Possible Causes and Symptoms of Endometriosis

1
Know that endometriosis may be caused by retrograde menstruation. During menstruation, sometimes the endometrial lining sheds from the uterus but does not exit the body. It can go into the fallopian tubes (attached to the uterus) and attach itself to pelvic surfaces instead of leaving the body through the vagina.
- In general, everyone who menstruates undergoes some degree of retrograde menstruation but does not develop endometriosis because their bodies clear the residual endometrial tissue before it forms deposits.
Growth of the faultily implanted endometrial tissue is dependent on the female hormone estrogen as its natural function is to stimulate cell growth. Thus along with the normal menstrual cycle, the displaced tissue also undergoes growth and shedding each month.
Bits of the endometrium may get dislodged and become embedded in an area outside of the womb during a gynecological operation accidentally.
This refers to a condition where cells that have similar properties to endometrial cells are deposited in the female reproductive tract during pregnancy when fetal organs are being formed. The primitive endometrial cells later get dislodged from the uterus and act like stem cells. This theory is supported by fetal autopsy.^{[16]XResearch sourceSignorile PG, Baldi F, Bussani R, D'Armiento M, De Falco M, Baldi A (April 2009)."Ectopic endometrium in human foetuses is a common event and sustains the theory of müllerianosis in the pathogenesis of endometriosis, a disease that predisposes to cancer". Journal of Experimental & Clinical Cancer Research 28: 49.}
Other factors that can cause endometriosis include immune system disorders, genetic predisposition and environmental toxins.^{[17]XResearch source Anger DL, Foster WG (2008). "The link between environmental toxicant exposure and endometriosis". Front. Biosci. 13: 1578–93.}
6
Recognize the possible signs and symptoms of endometriosis. The main symptom is persistent pelvic pain. Patient also complains of painful menses (dysmenorrhea), painful urination (dysuria), painful sex (dyspareunia) and severe pain in the legs.^{[18]XResearch sourceBallard K, Lane H, Hudelist G, Banerjee S, Wright J (June 2010). "Can specific pain symptoms help in the diagnosis of endometriosis? A cohort study of women with chronic pelvic pain". Fertil. Steril. 94 (1): 20–7.}
- The pain is because of the reaction of endometrial tissues to the hormonal activity. These lesions also bleed during the normal menstrual cycle due to which the blood collects in the surrounding areas leading to swelling and inflammation finally leading to pain.
- Pain can also occur due to adhesions that bind the internal organs together, thereby leading to their dislocation. So we see that many a times the fallopian tubes, ovaries, uterus, bowels and bladder are bounded leading to pain in day to day life too apart from the menstrual cycle.
- Patients may also complain of constipation, nausea, vomiting, chronic fatigue, low grade fever, irregular menses. Around 30-50% come with complains of infertility.
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