Estrogen and progesterone are the main hormones that control your menstrual cycle. Medicines can help control these hormones. This helps limit the swelling of all endometrial tissue. This treatment may be tried instead of surgery. Or, it may be used along with surgery. Some medical therapy prevents a woman from becoming pregnant. Common types of medical therapy include:
- GnRH agonists. These hormones stop the body from making estrogen. They help with pain and may be used with low doses of other hormones to help prevent side effects.
- Birth control pills. These prevent the hormone levels from fluctuating like they would during a normal menstrual cycle.
- Progestins. These are a form of progesterone. They help keep estrogen levels low.
- Danazol. This is a weak male hormone. It stops or lowers a woman’s production of estrogen and progesterone. This is less commonly used. A nonhormonal form of birth control must be used with this therapy.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These are analgesics that help with pain, but they do not treat the endometriosis.
If medical therapy doesn’t control the problem, surgery can be done. During surgery, endometrial implants may be removed. This may help women get pregnant if the endometriosis was causing fertility problems. If a woman does not want to get pregnant, in some cases, the uterus may be removed. This is called a hysterectomy. The ovaries may be removed along with the uterus. There are 2 techniques for doing surgery:
- Laparoscopy. This is surgery done through small incisions in your stomach. An instrument called a laparoscope (a thin, lighted tube) is used. It is put through 1 of the small incisions. Surgical tools are put through the other small incisions.
- Laparotomy. This is surgery done through 1 larger incision in your stomach. It is used to remove large implants that can’t be reached with the laparoscope. It may also be used when pelvic organs, such as your bowel, are involved.