Endometriosis treatment aims to manage symptoms such as pain, slow the growth of endometrial tissue, and improve fertility when needed. There is currently no cure, but several options exist:

Medical Treatments

• Pain relief: Over-the-counter painkillers like paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help reduce pain

• Hormonal therapies: These treatments suppress or alter hormone levels to reduce or stop menstruation, which slows endometriosis growth and eases pain. Options include:
  • Combined hormonal contraceptives (pills, patches, vaginal rings) that regulate hormones and reduce menstrual flow

* Progestin-only therapies, including intrauterine devices (e.g., Mirena), implants, injections, or pills, which stop periods and endometrial tissue growth

* Gonadotropin-releasing hormone (GnRH) agonists and antagonists that induce a temporary menopausal state by lowering estrogen, shrinking endometriosis lesions. These may be combined with low-dose hormones to mitigate side effects like hot flashes and bone loss

* Aromatase inhibitors, sometimes used alongside hormonal treatments, to further reduce estrogen levels

Surgical Treatments

• Conservative surgery: Laparoscopy (keyhole surgery) is used to diagnose and remove or destroy endometriosis tissue while preserving reproductive organs. Techniques include excision (cutting out tissue) and ablation (destroying tissue with heat or laser)

• More extensive surgery: In severe cases, removal of the uterus (hysterectomy), ovaries (oophorectomy), or affected parts of the bladder or bowel may be necessary

• Surgery may also improve fertility, especially in mild cases or when cysts (endometriomas) are removed

Supportive and Alternative Approaches

• Lifestyle modifications such as heat application, pelvic massage, rest, dietary changes, and herbal supplements may help alleviate symptoms

• Mental health support and fertility counseling are important aspects of comprehensive care

Summary

Treatment is individualized based on symptom severity, fertility goals, and response to prior therapies. Medical management with painkillers and hormonal treatments is often first-line, with surgery reserved for persistent symptoms or fertility issues. Continuous follow-up is important as symptoms can recur after stopping treatment