Treatment depends on the extent of the disease, the woman’s desire for future child bearing, the degree of symptoms experienced and the woman’s age.
Medical treatment includes painkillers that treat the discomfort of the disease. It may be indicated for women with mild to moderate menstrual pain, with no pelvic examination abnormalities and with no immediate desire to become pregnant.
Progestogens, which have some of the properties of the natural progesterone, can be beneficial. They are given continuously either alone or in combination with an oestrogen (as in a combined oral contraceptive pill), during several months in a row. However, this treatment cannot make scar tissues and nodules caused by the disease disappear. There can be side effects of depression or spotting, which may limit this option for treatment. Other medications, the so-called GnRH-analogs, cause a sharp decrease in the production of oestrogen and a condition that resembles that following the menopause. During the period of treatment, symptoms will abate. Unfortunately, because of the side effects of this therapy, it cannot be prolonged beyond three months.
Surgical treatment may consist of burning up endometrial implants with a thermocautery or a laser beam. This can presently be done via a laparoscope. The wall of endometriotic cysts of the ovaries can also be removed using this approach. What may work well for one woman may not help another. Usually, a combination of medications and surgical treatment tailored to the individual controls endometriosis. In case of advanced endometriosis, the doctor may suggest removal of the uterus and of the ovaries.