Endometriosis occurs when tissue similar to the uterus lining (endometrial-like tissue) grows outside the uterus. Endometrial-like tissue can typically form around your reproductive organs but can also expand beyond the pelvic area.
It’s a condition that affects up to 10% of women of reproductive age.
Although the symptoms vary by person, they often involve:
- severe period pain
- pelvic pain when you’re not on your period
- infertility
- irregular periods
- pain during intercourse
Several treatment options may help relieve endometriosis pain, such as medication, surgery, and natural remedies.
Sex and gender exist on a spectrum. We use the term “women” in this article to reflect the term assigned at birth. However, gender is solely about how you identify, independent of your physical body.
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve pain and inflammation. They work by blocking the production of prostaglandins, which are hormone-like substances that can cause pain and inflammation in the body.
A 2017 review did not find conclusive evidence that NSAIDs improve endometriosis pain. Still, these medications may be able to relieve mild to moderate symptoms, including menstrual cramps.
Examples of NSAIDs commonly used to treat endometriosis pain include:
They are usually available over the counter (OTC) in different prescription strengths and various forms, such as:
- tablets
- capsules
- liquids
It’s important that you remember to take them as directed and don’t exceed the recommended dosage. Longer-term use can have side effects like:
- stomach irritation
- stomach ulcers and bleeding
- increased risk of stroke
- high blood pressure
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2. Hormonal therapy
Hormonal therapy is another option that can help manage endometriosis pain, particularly for those who experience heavy bleeding and pain during menstruation.
It works by regulating the menstrual cycle and reducing the amount of estrogen in the body to slow down the growth of endometrial-like tissue outside the uterus.
While hormonal therapy can be effective, it may not be suitable for people with certain medical conditions, a history of breast cancer, or those who want to get pregnant.
Birth control pills
Combination oral birth control pills contain estrogen and progestogen. They can help treat endometriosis pain by regulating the menstrual cycle. This can result in less painful periods.
Progestin-only pills are another oral birth control option, containing a synthetic form of the hormone progesterone. They’re particularly useful for people who cannot take estrogen-containing contraceptives — for instance if they smoke or have other risk factors for heart disease.
Non-oral contraceptives
Other forms of contraceptives that prevent ovulation and reduce menstrual bleeding may also reduce endometriosis pain.
- injectable contraceptives
- hormonal intrauterine devices (IUDs)
- subdermal implants
- vaginal rings
Gonadotropin-releasing hormone (GnRH) agonists
GnRH agonists work to stop the production of estrogen in the body.
A 2021 review suggests that they can reduce endometriosis pain. But long-term use could result in menopause-like side effects.
Examples of GnRH agonists include:
They’re commonly delivered as a nasal spray or regular injections.
3. Opioids
Opioids are medications that work by binding to specific receptors in the brain and spinal cord to reduce the sensation of pain.
A 2023 review found that they can be effective for managing moderate to severe endometriosis pain.
Examples of opioids for endometriosis pain are:
These are available only by prescription. They come in various strengths and forms, such as:
- tablets
- capsules
- liquids
It’s important to know that opioids are associated with several potential risks and side effects, such as dependence and drowsiness.
If a healthcare professional prescribes opioids for your endometriosis pain, it’s important to take them as directed and not exceed the recommended dosage.
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A healthcare professional may recommend surgery to treat your pain if other treatments are ineffective or you have severe or widespread endometriosis.
Laparoscopy
The most common surgical option for endometriosis is a laparoscopy. This is a minimally invasive procedure where a camera is inserted into the abdomen through a small incision. The surgeon can then find and remove endometrial-like tissue outside the uterus.
Hysterectomy
Another option is a hysterectomy, which is the surgical removal of the uterus. Recent research suggests it can be effective in stopping endometriosis pain.
But it’s important to remember that this surgery removes the option of future pregnancy. It’s typically only recommended for those with severe endometriosis who are not responding to other treatments.
5. Natural remedies
Here are several natural remedies that may relieve endometriosis pain.
Heat therapy
A 2018 review notes that applying heat to the lower abdomen can reduce period-related pain. You can consider using the following:
- hot water bottles
- heating pads
- warm baths
Acupuncture
Acupuncture is a traditional Chinese practice that involves inserting thin needles into specific points of the body to help relieve pain. But more research is needed to determine the efficacy of acupuncture for endometriosis symptoms.
Herbal remedies
Even though research is not conclusive on their effectiveness, some people find relief with herbal remedies such as ginger and turmeric, as they have anti-inflammatory properties that can help with endometriosis inflammation.
You can add ginger and turmeric to warm water before drinking.
It’s important to note that some options may interact with other medications.
6. Lifestyle measures
Lifestyle measures can help manage endometriosis pain.
Exercise
A 2017 study notes that regular exercise can significantly reduce pain levels for endometriosis. It can also help improve overall health and well-being and manage weight.
Diet
A 2021 review suggests that certain foods can improve endometriosis symptoms. These include:
- fruits
- vegetables
- omega-3 fatty acids
Foods such as trans-unsaturated fatty acids and red meat may worsen endometriosis symptoms.
Stress management
A recent study suggests that stress and endometriosis may be linked, so taking steps to manage or minimize stressors in your life may be helpful.
Getting enough sleep with endometriosis pain
Getting enough restful sleep can be beneficial for your health and well-being.
A 2020 study notes that people with endometriosis often have poor sleep quality, leading to a poorer quality of life, bladder pain, and depression.
Here are some tips that may help.
- Sleep position: Sleeping on your side with a pillow between your knees can reduce pressure on your lower back and abdomen.
- Pain relief: Taking pain medication or using heat therapy before bed can help ease pain and improve sleep quality.
- Relaxation techniques: Practices such as meditation, deep breathing, and progressive muscle relaxation can help you fall asleep more easily.
Summary
You may be able to manage endometriosis pain through medication, natural remedies, and lifestyle measures.
As the endometriosis experience is unique to each person, consider speaking with a healthcare professional to help determine what may be best for you.
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