You have a condition called endometriosis. Symptoms of endometriosis include:

• Heavy painful menstrual bleeding
• Bleeding between periods
• Problems getting pregnant
• Chronic pelvic pain

Having this condition can interfere with your social and work life.

No one knows what causes endometriosis. There is also no cure. However, there are different ways to treat the symptoms. These treatments can also help relieve menstrual pain.

Learning how to manage your symptoms can make it easier to live with endometriosis.

Pelvic pain - living with endometriosis; Endometrial implant - living with endometriosis; Endometrioma - living with endometriosis

Your health care provider may prescribe different types of hormone therapy. These may be birth control pills or injections. Be sure to follow your provider's directions for taking these medicines. Do not stop taking them without talking with your provider. Be sure to tell your provider about any side effects.

Over-the-counter pain relievers can reduce the pain of endometriosis. These include:

• Ibuprofen (Advil)
• Naproxen (Aleve)
• Acetaminophen (Tylenol)

If the pain is worse during your periods, try starting these medicines 1 to 2 days before your period begins.

You may be receiving hormone therapy to prevent the endometriosis from becoming worse, such as:

• Birth control pills.
• Medicines that cause a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes.

Apply a hot water bottle or heating pad to your lower stomach. This can get blood flowing and relax your muscles. Warm baths also may help relieve pain.

Lie down and rest. Place a pillow under your knees when lying on your back. If you prefer to lie on your side, pull your knees up toward your chest. These positions help take the pressure off your back.

Get regular exercise. Exercise helps improve blood flow. It also triggers your body's natural painkillers, called endorphins.

Eat a balanced, healthy diet. Maintaining a healthy weight will help improve your overall health. Eating plenty of fiber can help keep you regular so you don't have to strain during bowel movements.

Techniques that also offer ways to relax and may help relieve pain include:

• Muscle relaxation
• Deep breathing
• Visualization
• Biofeedback
• Yoga

Some women find that acupuncture helps ease painful periods. Some studies show it also helps with long-term (chronic) pain.

If self-care for pain does not help, talk with your provider about other treatment options.

If medicines do not control your symptoms, your provider may suggest a pelvic laparoscopy procedure.

Contact your provider right away if you have severe pelvic pain.

Contact your provider for an appointment if:

• You have pain during or after sex
• Your periods become more painful
• You have blood in your urine or pain when you urinate
• You have blood in your stool, painful bowel movements, or a change in your bowel movements
• You are unable to become pregnant after trying for 1 year

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Brown J, Farquhar C. An overview of treatments for endometriosis. JAMA. 2015;313(3):296-297. PMID: 25603001 pubmed.ncbi.nlm.nih.gov/25603001/.

Burney RO, Giudice LC. Endometriosis. In: Robertson RP ed. DeGroot’s Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 125.

Hays BM, Hudson T. Endometriosis. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 5th ed. St Louis, MO: Elsevier; 2021:chap 166.

Kalaitzopoulos DR, Samartzis N, Kolovos GN, et al. Treatment of endometriosis: a review with comparison of 8 guidelines. BMC Womens Health. 2021;21(1):397. PMID: 34844587 pubmed.ncbi.nlm.nih.gov/34844587/.

Smith CA, Armour M, Zhu X, Li X, Lu ZY, Song J. Acupuncture for dysmenorrhoea. Cochrane Database Syst Rev. 2016;4:CD007854. PMID: 27087494 pubmed.ncbi.nlm.nih.gov/27087494/.