In the UK, one in 10 women has Endometriosis. With March marking Endometriosis Awareness Month, Dr Bhavini Shah, a GP from LloydsPharmacy Online Doctor, reveals ways to relieve endometriosis symptoms.

What is endometriosis? 

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, and difficulty getting pregnant.”

Dr Bhavini Shah, GP Online Doctor, LloydsPharmacy

7 ways to relieve endometriosis symptoms

1. Apply heat

According to Endometriosis UK, a hot water bottle or heated wheat bag can effectively 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.

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 might help with mild endometriosis pain when it occurs, but NSAIDs such as Ibuprofen should be taken the day before a period or pain is expected.

People with endometriosis will probably need something stronger, such as codeine, if it’s causing a lot of discomfort. However, codeine comes with potential side effects, such as constipation. Some people might need stronger pain relief. A GP can help manage pain associated with endometriosis.

4. TENS machines

A TENS machine (transcutaneous electrical nerve stimulation) helps ease aches and pains, including back and shoulder pain. 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 which is used to treat depression but can also help manage pain. Taking tricyclic antidepressants changes 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. This must first be discussed with a GP.

6. Hormonal treatments 

Hormone treatments such as the pill, the hormonal coil and the implant can be effective ways to relieve endometriosis symptoms.

Some hormonal treatments can stop the ovaries from being stimulated, meaning that production of oestrogen stops. Therefore, women might experience side effects causing a ‘menopause-like’ state.

7.Surgery

Several surgeries can help relieve the symptoms of endometriosis, and it is important to discuss with a doctor which surgery is best for the severity of the pain. The choice that is made is dependent on an entire range of factors such as age, whether or not children are wanted in the near future, and certain complications.

Endometriosis can be cut out or destroyed using heat or a laser via laparoscopy (keyhole surgery). Although this can provide relief from symptoms, they can return in time.

If endometriosis is severe, surgery could be more complex 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.