Endometriosis is a disease in which tissue resembling that which normally lines the uterus, called endometrium, starts to grow elsewhere and form lesions. These lesions respond to hormonal cycles in the same way as endometrium in a woman’s uterus, and swell and shed during each menstrual cycle. But the lesions cannot be expelled like normal endometrium. This can lead to inflammation, severe pain, and infertility in women.
Several approaches can be used to treat the pain caused by endometriosis, and many hospitals have a specialized pain clinic to provide advice and support to patients with endometriosis-associated pain, as well as chronic pain caused by other reasons.
Non-drug therapies
Some patients find that physiotherapy and warmth, such as hot baths or a hot water bottle, can ease pain linked to endometriosis, although these approaches are often more effective in combination with medications.
Some women also find that transcutaneous electrical nerve stimulation (TENS) can reduce pain. TENS is a technique where electrical pulses enter the body via the skin using a small machine. It is thought that these electrical pulses intercept the pain messages being sent to the brain.
The pulses may also help the body to produce endorphins, or hormones that interact with receptors in the brain that reduce a person’s perception of pain.
Non-steroidal anti-inflammatory drugs (NSAIDs)
For mild pain and inflammation relief, NSAIDs — such as acetaminophen, ibuprofen, diclofenac, naproxen, ketoprofen, and mefenamic acid — are sometimes prescribed. While some medications and some dosages are available over-the-counter, others can only be obtained by prescription.
It is important to remember that NSAIDs work by blocking the production of pain signals, not the brain’s perception of them. This means they must be taken before the pain becomes severe to be effective. Patients who are relying on these medications should ask their doctor or pharmacist about proper use for pain linked to endometriosis.
Opioid-based pain relievers
Opioid-based pain relievers, also called narcotic analgesics, affect receptors in the brain that perceive pain. This type of medication can be prescribed for endometriosis, and include hydrocodone, oxycodone, and hydromorphone. However, opioid-based pain relievers are highly addictive, and they should not be used long term and only as prescribed.
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