Treatment Options for Endometriosis
So you’ve been diagnosed with (or told that you likely have) endometriosis, or endo. You may have been told some alarming things as far as your options for treatment. You may have been told to have a baby, or have a hysterectomy, or that you need to take multiple forms of birth control at the same time in order to suppress your symptoms. I sure hope this isn’t the case, but in our experience these are usually the only “treatment options” presented at first to endo patients.
To be fair, the standard treatment for endo in a western medicine sense does start with medications. Non-steroidal anti inflammatories (NSAIDS, such as ibuprofen) are recommended to try to see if they can help manage painful symptoms. If those are not enough, hormonal contraceptives and additional medications such as aromatase inhibitors or progestin-only contraceptives may be trialed as well to reduce the effect and build up of estrogen in the body and control symptoms such as excessive bleeding. If you’re thinking that sounds like a band-aid approach at best, you’re right. It is meant to address the symptoms a patient may be suffering from, but does not necessarily do anything to address endo that is already present.
In order to address endo that is already present, laparoscopic excision surgery is required. It is super important to be honest with your endo excision specialist about what it means to take out anything in addition to the endo. Sometimes they may recommend removal of the appendix, sometimes the uterus and ovaries, and sometimes just the uterus. One of the biggest things to consider is if you want to preserve the ability to carry and deliver a child. If your uterus is removed, you will not be able to do this (although you could still harvest and preserve your eggs to use with a surrogate). Additionally, I want to be clear that removal of the uterus alone is NOT considered an evidence based approach to treating endo, nor is it always necessary to become symptom free. If you are being told this is your only option or your surgeon is suggesting hysterectomy without additional excision of the endometriosis, seek a second opinion.
While I’ve described the standard approach of western medicine when it comes to treating endo, I want you to know that there is no definitive cure for endo. I would instead describe the treatment goal to be similar to remission: where the disease is not proliferating and symptoms are managed. In order to achieve this, I want to address a number of additional lifestyle components to consider as part of your treatment plan:
nutritional therapy to assist with hormonal balancing and regulation
supplements to assist with inflammation and symptoms such as nausea and fatigue -stress management techniques to assist with hormonal regulation (see our stress management blog series)
appropriate exercise regimen to assist with pain management and hormone regulation -sleep strategies to ensure adequate rest for hormone balance
physical therapy strategies to assist with pain management and improve bowel and bladder function
additional adjunct therapies that may be helpful: mental health treatment, acupuncture, massage, chiropractic care, etc.
While this may seem like a lot, it is important to understand that each item on the list above assists your body with hormonal regulation and overall wellness. Working with a functional medicine practitioner or naturopathic doctor is a great place to start in order to help you with many of the strategies listed above. If pain is unmanageable and/or bowel and bladder function have been affected, we would also highly recommend seeing a pelvic floor physical therapist. Each of these professionals can help you determine which strategies will be the most beneficial for you so that it is not so overwhelming. Managing endo is really a lifelong process for most patients, so finding professionals you can trust and return to as needed is one of the best steps you can take.
Having found our page you are already well on your way to understanding and implementing these lifestyle or ‘conservative management’ strategies. Almost everything we share with regards to hormone balance, blood sugar regulation, sleep, exercise and stress management will be applicable and fall under this category of management.
You got this girl! I want you to know you are not alone! Like I mentioned in the first blog of this series, 1 in 10 women are dealing with this in some capacity. There is a community of women fighting for better support and services for people with endometriosis. And, you’ve got us! We’re here to support you every step of the way.
