The condition affects millions worldwide and is often brushed off my some doctors as ‘normal’
March marks Endometriosis Awareness Month and with millions of women seeking ways to manage this painful condition – whether diagnosed or suspected – it is often misunderstood. Doctor Bhavini Shah, GP at LloydsPharmacy Online Doctor, has said there are many ways to relieve endometriosis symptoms, from heat therapy and physiotherapy to hormonal treatments and surgical options.
Each person differs when it comes to symptoms as well as how painful it can be. Whilst some people can have mild symptoms, other people can have it so debilitating that they are bedbound for days, and at times, weeks. So what is it and how can you ease symptoms?
What is endometriosis?
Dr Shah explains, “Endometriosis is where cells similar to those in the uterus grow in other parts of the body. It affects reproductive-age women and girls and can cause chronic pain during periods, sex and urination, and also causes bloating.
“There is no known cure, and treatment is focused on managing pain symptoms. The main symptoms of endometriosis can include painful periods that interfere with daily life, heavy menstrual bleeding, pelvic pain, irregular periods and pain during or after intercourse.”
Other symptoms include:
- Irregular or heavy periods
- pelvic pain when either passing urine or opening the bowel
- fatigue
- difficulty getting pregnant
7 ways to relieve endometriosis symptoms
1. Apply Heat
According to Endometriosis UK, a hot water bottle or heated wheat bag can relieve endometriosis pain. Additionally, a hot bath can relax the pelvic muscles, improve blood flow, and enhance nerve conduction, alleviating some of the pain.
Do not put any heat directly on the skin surface, the doctor warns. Heat – or even cold therapy – may not work for everyone so keep trying until you find a safe method that suits you.
2. Physiotherapy
Physiotherapists can develop a program of exercise and relaxation techniques designed to help strengthen, or relax, pelvic floor muscles, reduce pain, and manage stress and anxiety.
3. Painkillers
Painkillers like paracetamol may provide relief for mild endometriosis pain, while NSAIDs like ibuprofen are more effective if taken the day before a period or anticipated pain.
For those experiencing more severe discomfort, stronger medications such as codeine may be necessary, though it can cause side effects like constipation. In some cases, even stronger pain relief may be required. A GP can offer guidance on managing endometriosis-related pain.
4. TENS machines
A TENS machine – which stands for transcutaneous electrical nerve stimulation – eases aches and pains – including back and shoulder pain which can occur with endo. As a drug-free option, TENS machines can be used alongside medication to relieve muscular pain and aching joints.
A TENS machine uses electrodes that are attached to the skin and emit vibrations that help to relax the muscles. Whilst not painful, people with heart conditions or who are pregnant should not use TENS machines. A discussion with a GP must be had before using this option.
5. Amitriptyline
Amitriptyline is a pain-modifying drug used to treat depression. However it can also help pain as it can change the way the body perceives pain by preventing the pain from reaching the brain. The doses that are given to treat endometriosis are smaller than the doses used to treat depression, and can be taken in tablet or liquid form, but you need to ask your GP about this first.
6. Hormonal treatments
The pill, coil and the implant can be effective ways to relieve endometriosis symptoms. For some, women’s periods stop and this can help with the pain. It may also lessen some symptoms, but again, this should be discussed with your GP.
7. Surgery
Various surgical procedures can help alleviate endometriosis symptoms, and it is essential to consult a doctor to determine the most suitable option. The decision depends on multiple factors, including age, future plans for having children and any existing complications.
Endometriosis tissue can be removed during laparoscopic (keyhole) surgery. While this may offer symptom relief, there is a possibility that symptoms could return over time.
However in some cases, “if endometriosis is severe, surgery could be more complex”, the doctor says. “If it involves either the bladder or the bowel. This surgery will be the same as a laparoscopy, but it will involve more surgeons, such as a colorectal surgeon.
“A hysterectomy is a surgery that removes the womb, with or without removing the ovaries. If the ovaries are left, there is a chance that endometriosis might return.
“A hysterectomy isn’t the right option for everyone, and it’s not a decision to take lightly. It’s important to explore all other options first and discuss them with a GP or gynaecologist.
“An oophorectomy surgery is the removal of one or both ovaries. If both ovaries are removed, this is called a bilateral oophorectomy, which causes irreversible menopause.
“These procedures may be considered for various personal reasons. Since they are irreversible, it’s important to discuss the benefits and risks in detail with a consultant before making a decision.”