Hormonal medications, such as contraceptives and progestins, can help manage symptoms of endometriosis and reduce the growth of endometrial tissue.

Endometriosis is a gynecological condition where uterine-like tissue grows outside of the uterus, leading to pain and potential fertility issues.

While there is no definitive cure, various treatments aim to manage symptoms and improve quality of life. A gynecologist can recommend medications that may help.

Combined hormonal contraceptives (birth control pills) containing ethinyl estradiol (an estrogen) and progestins (synthetic progesterones) are a common first-line therapy for endometriosis.

Progestin-only pills can also help treat endometriosis. They may be useful for people who cannot take combined contraceptives or in cases where symptoms do not respond to combined hormonal therapy.

Other options include gonadotropin-releasing hormone (GnRH) agonists and antagonists, which can be an effective way of managing the hormones that affect endometriosis.

However, these medications can have side effects and limitations on their duration of use.

GnRH antagonists such as relugolix and linzagolix are currently under evaluation.

While there’s no cure for endometriosis, medical treatment can effectively reduce painful symptoms, improving overall quality of life.

Medication for endometriosis can help:

  • relieve pain
  • reduce menstrual symptoms, such as cramps and discomfort
  • regulate the menstrual cycle
  • improve emotional well-being due to pain relief
  • improve sleep

How does medication for endometriosis work?

Some ways in which hormonal contraceptives can help include the following:

  • Manage menstrual bleeding: Many people with endometriosis experience painful menses, so by managing or eliminating menstrual bleeding, the symptoms associated with endometriosis can improve.
  • Prevent ovulation: Ovulation is the release of an egg from the ovary. By preventing ovulation, these medications aim to reduce the hormonal changes that contribute to endometriosis.
  • Anti-inflammatory effects: Endometriosis involves inflammation, and these medications have properties that can help reduce inflammation, which is a source of pain.

GnRH agonists work by temporarily increasing hormones and then downregulating GnRH receptors to cause lower estrogen levels (hypoestrogenic state). They also suppress ovarian estrogen production, creating a temporary menopausal state.

On the other hand, GnRH antagonists work by blocking GnRH effects to rapidly suppress estrogen without an initial surge. They also create a temporary menopausal state, reducing menstrual pain.

Aside from medications, other medical treatment options for endometriosis include:

  • Hormonal IUD: This intrauterine device (IUD) releases hormones to reduce pain and bleeding.
  • Laparoscopy: This is a minimally invasive surgery to remove endometrial tissue.
  • Laparotomy: In severe cases, this type of open abdominal surgery may be needed.
  • Hysterectomy: In very severe cases, removal of the uterus may be recommended.

Lifestyle changes

Some lifestyle changes can also help with managing symptoms of endometriosis. Examples include:

  • Dietary modifications: Some individuals find relief by avoiding certain foods, such as those with gluten.
  • Exercise: Some evidence suggests that exercise may help relieve endometriosis-related pain, but more high quality studies are necessary.
  • Stress management: Techniques such as yoga or meditation may provide relief. A 2022 study found that a brief mindfulness-based intervention significantly improved pelvic pain and dyschezia (difficulty passing stool) immediately after treatment. Mental health and vitality scores also improved in the follow-up period.

Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus.

While there isn’t currently a cure, medications such as hormonal contraceptives, progestins, and GnRH agonists can manage symptoms by reducing inflammation, preventing ovulation, and targeting endometrial tissue growing outside the uterus.

Lifestyle changes may also offer additional relief. In some cases, surgery may be necessary.

If you’re experiencing symptoms, consult a healthcare professional to explore suitable treatment options.