What is the best medication for endometriosis? 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Sellers, BS Pharmacy, PharmD — By Amanda Barrell on August 18, 2022The best medication for endometriosis depends on multiple factors, including a person’s age, their symptoms, and whether they want to get pregnant. There is no cure for endometriosis, but hormone therapy, pain relievers, and hormonal contraceptives may improve the symptoms. Surgery is also an option. This article will look at the medications and other treatments a doctor may suggest for endometriosis. A note about sex and gender Sex and gender exist on spectrums. This article will use the terms, “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more. Overview Share on PinterestDesign by MNT; Photography by PeopleImages/Getty Images & Owaki/Kulla/Getty ImagesEndometriosis is a chronic condition that occurs when tissue similar to the lining of the uterus grows in other areas of the body. When the tissue bleeds in response to changes in hormone levels, it can cause inflammation and pain. Endometriosis affects 11% of females aged 15–44 in the United States. This condition can make it harder to get pregnant and, in some cases, can lead to infertility. The symptoms include:very painful menstrual crampslower back or pelvic pain that does not go awaypain during sexpain or cramps after sexpain in the intestinespain during bowel movements or pain when urinating during menstruationspots of blood in the stool or urine during menstruationdiarrhea, constipation, bloating, or nausea during menstruationspotting or bleeding between periods Learn more about endometriosis and infertility. Medical treatments for endometriosis Endometriosis has no cure. However, doctors can recommend ways to help ease the symptoms. The best medication for endometriosis will depend on multiple factors, including the person’s age, the severity of their symptoms, and whether they want to get pregnant. Hormonal contraceptives If a person is not trying to get pregnant, doctors may suggest that they use hormonal birth control to manage endometriosis symptoms. Hormonal contraceptives can make periods shorter, lighter, and more regular and help ease the menstruation-related symptoms of endometriosis, including pain. This works best in people whose pain and other symptoms are not severe. This section looks at some examples of hormonal contraceptives. Estrogen and progestin pill Doctors usually prescribe this type of oral contraceptive to prevent pregnancy. They may also recommend it for people with endometriosis because it can make a person’s periods lighter and less painful. The pill contains two female sex hormones: estrogen and progestin. This combination prevents ovulation, the release of eggs from the ovaries. Doctors will recommend that a person take this pill every day. Some people will need to take the pill every day for 21 days and then have a 7-day break for a period. Others will take it continuously. Progestin-only pill POP Some females, including those with cardiovascular disease and those at a high risk of developing blood clots, cannot take estrogen. In these cases, doctors may recommend the POP. The POP contains only one female hormone, progestin. It works by preventing ovulation and changing the mucus that lines the uterus. A person will have to take this pill at the same time every day for it to be effective. A doctor will recommend taking this pill every day without a 7-day break. Progestin intrauterine device IUD An IUD is a small, T-shaped piece of plastic that a healthcare professional can insert into a person’s uterus. There are different types, including a hormonal progestin IUD and a nonhormonal copper IUD. A progestin IUD releases tiny amounts of the hormone progestin into the body over time. Doctors mainly recommend it to prevent pregnancy, but it may also reduce endometriosis pain. According to the National Institutes of Health (NIH), the progestin IUD may reduce the size of endometriosis lesions and make periods lighter. Risks and side effects Hormonal contraception is not a good endometriosis treatment option for people who want to get pregnant. It is also worth noting that hormonal contraceptives will ease the symptoms for only as long as the person uses them. These medications can also have side effects, such as:weight gainbloatingbleeding between periods A person should always discuss risks and side effects with a doctor before taking any new medication. Learn more Learn more about hormonal contraceptives and endometriosis. Birth control for endometriosisWhat to know about the IUD for endometriosis10 most common birth control pill side effects Hormone therapy Hormones cause the patches of endometriosis tissue to bleed in response to a person’s menstrual cycle. Because of this, changing a person’s hormone levels may stop the tissue from bleeding and relieve some endometriosis symptoms. Hormones may also slow the growth of the tissue. Hormone treatments stop periods, so they are suitable only for those who do not want to get pregnant. They stop the ovaries from producing hormones, including estrogen. This section looks at the typical hormone therapies a doctor may suggest for endometriosis. Gonadotropin-releasing hormone GnRH agonists These drugs stop ovulation and send the body into a “menopausal state.” This stops the endometriosis from getting any worse. GnRH agonists come in the form of pills, injections, or nasal spray. Healthcare professionals usually recommend taking GnRH agonists for no longer than 6–24 months at a time, depending on the dosage. This is because taking them for longer increases the risk of bone loss and heart complications. Examples include:leuprolide acetate, or Lupron Depotgoserelin, or Zoladex nafarelin, or Synarel elagolix, or Orilissa Aromatase inhibitors Aromatase inhibitors lower estrogen levels. According to the NIH, some research has shown that these could be useful for treating endometriosis pain. However, the Food and Drug Administration has not yet approved them for this purpose in the U.S. Researchers still consider this an experimental approach. Danazol Danazol lowers estrogen levels and increases levels of the male sex hormone androgen. This stops ovulation and periods, easing the symptoms of endometriosis. Risks and side effects Hormonal treatments, such as hormonal contraceptives and hormone therapy, last only as long as the person takes them. When a person stops taking the medication, the symptoms will return. Possible side effects of hormonal treatments include:hot flashestiredness and sleep problemsheadachedepressionbone lossjoint and muscle stiffnessvaginal dryness Some hormonal medications, such as GnRH agonists, can increase the risk of heart complications. Possible side effects of Danazol include oily skin, acne, and breast soreness. Danazol can also harm a developing fetus. People who take it should avoid hormonal birth control. Instead, those who use Danazol should use barrier methods of contraception, such as condoms or a diaphragm, to prevent pregnancy. Pain relief medication A type of pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs) can help ease mild pain and other symptoms of endometriosis. These medications work by slowing the body’s production of prostaglandins, a type of hormone involved in the inflammation that contributes to pain. Common types of NSAIDs include:naproxenibuprofenaspirin Risks and side effects Some possible side effects of NSAIDs such as ibuprofen are:constipationdiarrheadizziness NSAIDs may also cause stomach ulcers and internal bleeding. Other treatments This section looks at other treatments for endometriosis, such as surgery and lifestyle changes. Surgery Sometimes, doctors may suggest removing some or all of the endometriosis tissue. This can ease the pain, but it will not cure the condition. The endometriosis can still come back. Doctors will usually recommend surgery only when the pain is severe. They may suggest one of the following operations:Laparoscopy: The surgeon inflates the lower abdomen and then makes two or more small cuts. They then insert a small viewing instrument with a light on the end. Next, the surgeon uses a laser to remove the endometriosis tissue.Laparotomy: During a laparotomy, instead of making smaller cuts, the doctor makes a large incision to examine the organs. They may then remove any endometriosis tissue they find. A surgeon may recommend this to someone with deeply infiltrative endometriosis. Hysterectomy: This is a major operation in which the surgeon removes the uterus. Doctors tend to recommend a hysterectomy as a last resort.Learn more Learn more about surgery for endometriosis. What to expect from a laparoscopy for endometriosisEndometriosis surgery: Laparoscopy, hysterectomy, and recoveryWhat is laparoscopic surgery for endometriosis? Diet and nutrition According to a 2021 review, some foods may have a positive or negative effect on endometriosis symptoms. The researchers suggest that taking fish oil capsules alongside vitamin B12 may have a positive impact on endometriosis symptoms. However, consuming alcohol, red meat, and trans fats could cause negative effects. Additionally, eating a balanced diet that contains a range of fruits and vegetables may help prevent endometriosis from developing or worsening. A 2015 review suggests that a nutritious diet may benefit endometriosis. The review notes that the following foods may be beneficial:fruitsvegetableswhole grainsfoods containing omega-3 fatty acids A person with endometriosis may want to keep a food journal and observe whether their symptoms worsen or improve depending on their diet. Identifying and limiting any problematic foods may help a person relieve their symptoms. Learn more Learn more about diet. What should you eat if you have endometriosis?Anti-inflammatory diet: What to knowWhat are the benefits of eating healthy? Lifestyle changes Doctors are not sure of the link between lifestyle and endometriosis. Studies are ongoing, but some of the headlines from the latest research are as follows:Avoiding alcohol: The 2021 review indicates that higher alcohol consumption may contribute to the risk of developing endometriosis. The researchers suggest that people with endometriosis avoid alcohol. Following a low fat diet: A diet high in trans fats may contribute to the risk of developing endometriosis.Physical activity: Researchers are unsure whether exercise can help ease the symptoms of endometriosis. A 2017 review suggests that physical activity may reduce pain and improve quality of life in adults living with chronic pain, although the researchers did not find this in all studies. Yoga: In a 2016 study involving 15 women with pain-associated endometriosis, researchers found that practicing yoga for 8 weeks helped the women manage their pain. Learn more Learn more about help and advice for living with endometriosis. How to cope with endometriosisHow to prevent endometriosis pain during sex9 home remedies for treating endometriosis symptoms Summary Endometriosis happens when tissue similar to the lining of the uterus grows outside the uterus. It can be very painful, particularly during menstruation. In some cases, it can lead to infertility. There is no cure for endometriosis. Doctors can suggest ways to manage the symptoms, including hormonal contraceptives, hormone therapies, and over-the-counter pain medicines such as NSAIDs. In severe cases, doctors may recommend surgery. Last medically reviewed on August 18, 2022EndometriosisDrugsPain / AnestheticsWomen's Health / Gynecology 12 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Endometriosis. (2021).https://www.womenshealth.gov/a-z-topics/endometriosisEndometriosis. (2022).https://medlineplus.gov/endometriosis.htmlEstrogen and progestin (oral contraceptives). (2015).https://medlineplus.gov/druginfo/meds/a601050.htmlGeneen, L. J., et al. (2017). Physical activity and exercise for chronic pain in adults: An overview of Cochrane reviews.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461882/Gonçalves, A. V., et al. (2017). A qualitative study on the practice of yoga for women with pain-associated endometriosis [Abtract].https://pubmed.ncbi.nlm.nih.gov/27552065/Gunaydin, C., et al. (2018). Effects of nonsteroidal anti-inflammatory drugs at the molecular level.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039135/Halpern, G., et al. (2015). Nutritional aspects related to endometriosis.https://www.scielo.br/j/ramb/a/FCFF8JMHW7YqL9RN6w38xPp/?lang=enHelbig, M., et al. (2021). Does nutrition affect endometriosis?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870287/Ibuprofen. (2022).https://medlineplus.gov/druginfo/meds/a682159.htmlProgestin-only (norethindrone) oral contraceptives. (2021).https://medlineplus.gov/druginfo/meds/a602008.htmlTennfjord, M. K., et al. (2021). Effect of physical activity and exercise on endometriosis-associated symptoms: A systematic review.https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01500-4What are the treatments for endometriosis? (2020).https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatmentFEEDBACK:Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD — By Amanda Barrell on August 18, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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