Prevention

Endometriosis cannot be prevented. This is in part because the cause is poorly understood. But long-term use of birth control hormones (patch, pills, or ring) may prevent endometriosis from becoming worse.

Home Treatment

Home treatment may ease the pain of endometriosis. You can try the following things along with your other treatments.

• Apply heat to your lower belly. Use a heating pad or hot water bottle, or take a warm bath. Heat improves blood flow and may relieve pelvic pain.
• Lie down and place a pillow under your knees. When you lie on your side, bring your knees up to your chest to relieve back pressure.
• Use relaxation techniques and biofeedback.
• Exercise regularly. It improves blood flow, increases pain-relieving endorphins naturally made by the body, and reduces pain.
• Try sexual activity. This may (or may not) help with cramping and backaches.

Medications

Medicines can be used to reduce pain and bleeding and, in some cases, to shrink endometriosis growths. For women who are not trying to get pregnant, birth control hormones and anti-inflammatories (NSAIDs) are usually recommended first. They are least likely to cause serious side effects and can be a long-term treatment option.¹ But if infertility from endometriosis is your main problem, medicines are generally not used.

Anti-inflammatories (NSAIDs)

• Anti-inflammatories (NSAIDs) reduce pain, inflammation, and bleeding from endometrial tissue. Check with your doctor before you use a nonprescription medicine for more than a few days. (If there is a chance that you are or could soon become pregnant, don't use an NSAID. They have been linked to increased miscarriage risk, especially when used at the time of conception and when used for longer than a week.⁶)
  • Start taking the recommended dose as soon as your discomfort begins or the day before your menstrual period is scheduled to start.
  • Take the medicine in regularly scheduled doses. Taking the medicine only when your pain is severe is not as effective.
  • If one type of NSAID doesn't relieve your pain, try another type. Or try acetaminophen, such as Tylenol.

Hormone therapy

• Birth control hormones (patch, pills, or ring) stop monthly ovulation and the growth, shedding, and bleeding that makes endometriosis painful. Birth control hormones improve endometriosis pain for most women.⁴ And they are the hormone therapy that is least likely to cause bad side effects. For this reason, many women can use them for years. Other hormone therapies can only be used for several months to 2 years. For more general information on birth control hormones, see Birth Control Pills, Patch, or Ring.
• Gonadotropin-releasing hormone agonist (GnRH-a) therapy lowers estrogen, triggering a menopause-like state. This shrinks implants and reduces pain for most women.
• Progestin (pills or Depo-Provera shot) stops ovulation and lowers estrogen. For most women, it shrinks endometriosis growths and reduces pain. Some studies show that the levonorgestrel intrauterine device (IUD) decreases pain.⁷
• Danazol therapy lowers estrogen levels and raises androgen levels, triggering a menopause-like state. This shrinks growths and reduces pain for most women. This relief usually lasts for 6 to 12 months after treatment. But danazol side effects can be significant.

All hormone therapies for endometriosis can cause side effects and pose certain health risks. Some cause especially unpleasant side effects. Before starting a medicine or hormone therapy, review its possible side effects. If they sound less difficult than your endometriosis symptoms, discuss the therapy with your doctor.

Endometriosis: Should I Use Hormone Therapy?

What to think about

Ovarian cancer risk is higher in women who have endometriosis. Using birth control hormones for 5 or more years lowers this risk.⁸