Women are more likely to have good long-term outcomes when they get an early referral and help from a specialist medical team. For example, doctors, gynaecologists, surgeons with special training and pelvic floor physiotherapists.
There isn’t a single ‘best’ treatment for endometriosis that works for everyone. Your medical team should consider your symptoms, preferences and priorities when recommending treatment options.
On this page we explain different treatments including pain-relief medicines, hormone medicines, surgery, combined treatments and non-medical options.
Pain control for endometriosis
Hormone medicines for endometriosis
Non-hormone medicines for endometriosis
Surgery for endometriosis
Combined treatments for endometriosis
Pelvic floor physiotherapy for endometriosis
Your doctor may recommend pain-relief medicines, such as paracetamol and non-steroidal anti-inflammatory drugs, for example, ibuprofen, for temporary relief. But if they don’t help with the pain, you may need other types of pain management.
Hormone medicines aim to reduce pain and the severity of endometriosis by slowing the growth of endometriosis. But symptoms can come back if you stop using these medicines.
Depending on your situation, your doctor may recommend the following medicines:
Talk to your doctor about the benefits and risks of each treatment.
Note that hormone medicines will prevent conception, so they are not recommended if you’re planning to get pregnant.
When you take the Pill continuously, by skipping the sugar (hormone-free) pills, it:
It also provides contraception if needed. But you don’t need to be sexually active to take the Pill.
Possible side effects include:
Your doctor may not recommend the Pill in some cases. For example:
Progestogens (natural and synthetic forms) relieve pain for many women with endometriosis.
You can take progestogens as a daily pill, or you can choose a long-acting option such as an injection or IUD.
Possible side effects include:
If you have severe symptoms, and you’ve tried other treatments like the Pill or progestogens, your doctor may recommend GnRH treatment. It’s important to ask about the benefits and risks before taking this treatment.
GnRH treatment creates a temporary medically induced menopause, which may cause menopausal symptoms and increase the risk of developing osteoporosis.
This treatment may be recommended for women with moderate to severe pain and women whose symptoms haven’t improved after other medicines or surgery.
Endometriosis medicine is now cheaper
The progestin medicine, dienogest, used to treat endometriosis, has been added to the Australian Pharmaceutical Benefits Scheme (PBS). This means the medicine is a lot cheaper.
Some antidepressant medicines affect the central nervous system’s response to pain. These medicines may help manage persistent pelvic pain associated with endometriosis.
Most surgery for endometriosis is performed via keyhole surgery (laparoscopy). The aim of surgery is to remove endometriosis lesions, repair damage to organs and improve symptoms. It’s important to choose a surgeon with lots of experience in this field.
The first operation has the best chance of removing the endometriosis. Additional surgeries may cause scarring and be less effective. Every surgery comes with the risk of complications, so it’s important to minimise surgeries where possible.
If endometriosis is in the bowel or bladder, the procedure is more complex and other specialists, for example, a urologist or bowel surgeon, may be involved in the surgery.
We need more research to show that surgery reduces pain or quality of life for people with endometriosis. After surgery, symptoms come back in about 40% of women.
A hysterectomy is an operation to remove the uterus (womb), cervix and fallopian tubes. The ovaries are usually left in the body to minimise the risk of medically induced menopause.
This surgery may be performed if you have severe pain or heavy menstrual bleeding and have tried all other options to improve your symptoms. It should only be performed if you don’t want to get pregnant in the future.
There is limited evidence to show that endometriosis symptoms improve after a hysterectomy. Endometriosis can also return after a hysterectomy.
It’s important to discuss the risks and benefits of this operation with your doctor before making a decision.
Talk to your doctor about a combination of surgery and ongoing hormone medicines. If you don’t plan to get pregnant straight after surgery, they may recommend you use hormone therapy to reduce pain and the return of symptoms.
Many people use non-medical options to manage symptoms of endometriosis. For example:
These options may help you cope with endometriosis. But more research is needed to show their effectiveness.
Learn more about living with endometriosis.
Some women use natural therapies to manage their symptoms and improve their quality of life.
Natural therapies include supplements (vitamins, minerals and fish oils), herbal medicine (tea, tablets and liquids) and nutrition.
There haven’t been many large studies about the effectiveness of natural therapies in managing endometriosis symptoms.
Note that natural therapies should be prescribed by a health practitioner trained in their use. It’s important to tell your doctor if you use these, as some natural therapies can affect other prescribed medicines.
Learn more about natural therapies.
Omega-3 fats are often recommended for endometriosis to help with inflammation and chronic pain. You can increase the amount of omega-3 fats in your diet by eating oily fish, linseeds, flaxseed oil, hemp seeds and walnuts. You can also take supplements. More research is needed to understand how omega-3 fats might help with inflammation.
Herbal medicines used to reduce inflammation and pain include ginger and turmeric. While there is some evidence that these medicines may help inflammation-based conditions, more studies are needed in this area.
Traditional herbal medicines used for general period pain include cramp bark, black haw and wild yam. But there isn’t enough evidence to suggest these medicines are effective for treating endometriosis-related pain.
A few small studies have explored the use of magnesium supplements to reduce general period pain. The results are promising, but larger studies are needed to confirm the findings.
Smaller studies have found that acupuncture may reduce endometriosis-related pain. But larger, higher-quality trials are needed in this area.
Traditional Chinese medicines may also be recommended for conditions such as endometriosis, but more studies are needed to understand how they work and if they are effective.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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