When endometriosis is acknowledged and treated, most women with the condition do well. Your doctor can help coordinate a team of experienced health professionals to provide quality care. Your team may include a gynaecologist, specialist surgeon and pelvic floor physiotherapist.
On this page we explain different treatments for endometriosis, including hormone and non-hormone medicines, non-drug treatments, natural therapies and surgery.
Managing endometriosis
Pain control for endometriosis
Hormone medicines for endometriosis
Antidepressant medicines for endometriosis
Surgery for endometriosis
Combined treatments for endometriosis
Pelvic floor physiotherapy for endometriosis
Other treatments for endometriosis
Natural therapies for endometriosis
In this short video, Dr Pav Nanayakkara, gynaecologist and advanced laparoscopic surgeon from Jean Hailes Clinics talks about endometriosis and how to manage the condition.
Your doctor may recommend pain-relief medicines, such as paracetamol and non-steroidal anti-inflammatory drugs, for example, ibuprofen for temporary relief.
Hormone medicines for endometriosis include the Pill, progestogens and gonadotrophin-releasing hormone analogues (GnRHa).
Hormone medicines may reduce the pain and severity of the endometriosis by suppressing the growth of endometrial cells and stopping any bleeding. But symptoms can return if you stop the treatment.
Talk to your doctor about the benefits and risks of each treatment. Note that hormone medicines aren’t suitable if you want to get pregnant.
When you take the Pill continuously, by skipping the sugar (hormone-free) pills, it:
It also provides contraception if needed. But you don’t need to be sexually active to take the Pill.
Possible side effects include:
Serious side effects, such as blood clots (thrombosis), are rare. If you experience chest pain, severe headache, severe pain or swelling in your leg, see your doctor.
Your doctor may recommend you don’t take the Pill if you:
Progestogens (natural and synthetic forms) provide pain relief for many women with endometriosis.
We don’t know exactly how progestogens relieve the symptoms of endometriosis. They may slow or stop the growth of endometriosis, causing it to gradually shrink and disappear.
You can take progestogens as a daily pill, or you can choose a long-acting option such as an injection or IUD (intrauterine device).
Possible side effects include:
GnRHa treatment is usually used for moderate to severe endometriosis.
GnRHa stops ovulation, which results in reduced oestrogen hormone levels in the body. This slows or stops the growth of the endometrial tissue, causing it to gradually shrink and disappear.
GnRHa treatment creates a temporary menopause, which may cause symptoms such as:
GnRHa can also increase your risk of developing osteoporosis. Talk to your doctor about having a bone density scan (DXA) before treatment. You can also have oestrogen therapy after treatment to stop bone loss and manage menopausal symptoms.
Endometriosis usually goes away after menopause. While uncommon, it can return with the use of menopausal hormone therapy (MHT), especially if the therapy doesn’t include progestogen.
Around the time of menopause, women with endometriosis are often advised to have combined MHT, even if they no longer have a uterus. This is because therapy with oestrogen alone may increase the risk of endometriosis symptoms returning. It can also increase the risk of cancer.
Endometriosis medicine now cheaper
In December 2024, the endometriosis medicine dienogest was added to the Australian Pharmaceutical Benefits Scheme (PBS). This means the medicine will be a lot cheaper.
Some antidepressant medicines are used to treat endometriosis. These non-hormone medicines affect the central nervous system’s response to pain. But there is limited research to show this is an effective treatment for endometriosis.
Most surgery for endometriosis is performed via keyhole surgery (laparoscopy). The goal of surgery is to achieve the best outcome and reduce the need for more operations in the future.
The first operation offers the best chance of removing the endometrial tissue, minimising the development of adhesions and improving long-term outcomes.
It’s important to choose a surgeon with advanced laparoscopic surgical skills to perform this operation. These specialists have extensive experience in managing the condition, minimising complications and improving outcomes.
If endometriosis is in the bowel or bladder, a urologist or colorectal surgeon may be involved in the procedure.
Many studies have shown that surgery improves symptoms and overall quality of life for women with endometriosis.
Depending on your situation, your specialist may recommend:
Talk to your specialist about the potential benefits and risks of each option before you decide.
A hysterectomy is the removal of the uterus, and sometimes removal of the ovaries and tubes. This surgery is usually performed when women have severe pain and have tried all other options to improve their symptoms. It should only be recommended if you don't want to get pregnant in the future.
Most of the hysterectomies performed remove both fallopian tubes but leave the ovaries behind. This helps to prevent surgical menopause.
If you experience menopausal symptoms after your operation, ask your doctor for a referral to a specialist clinic for early menopause management.
Surgery by laparoscopy is an effective way to treat endometriosis. But a combination of surgery and hormone medicines can improve outcomes.
Hormone medicines are sometimes used prior to surgery, to shrink the endometriosis, and again after surgery.
Studies suggest there is a delay in endometriosis recurring if surgery is followed by treatment with GnRHa, the Pill or certain intrauterine devices (IUDs).
A pelvic floor physiotherapist can help you to reduce pelvic pain symptoms. They will assess your pain and teach you gentle stretches and exercises. They can also help if you are experiencing painful sex.
You do not need a doctor’s referral to see a pelvic floor physiotherapist.
Learn more about your pelvic floor.
You can try other treatments for endometriosis, such as psychology (specifically cognitive behavioural therapy), diet and physical activity, but few studies have evaluated the benefits.
Learn more about living with endometriosis
Many people with endometriosis use natural therapies to manage their symptoms and improve their quality of life.
One study found that women with endometriosis commonly use naturopathy. Another study found just under half of people surveyed used meditation or breathing exercises to help manage pain.
Natural therapies include supplements (vitamins, minerals and fish oils), herbal medicine (tea, tablets and liquids) and nutrition.
There haven’t been many large studies about the effectiveness of natural therapies in managing endometriosis symptoms.
Note that natural therapies should be prescribed by a health practitioner trained in their use. It’s important to tell your doctor if you use these, as some natural therapies can affect other prescribed medicines.
Learn more about natural therapies.
Omega-3 fats are often recommended for endometriosis to help with inflammation and chronic pain. You can increase the amount of omega-3 fats in your diet by eating oily fish, linseeds, flaxseed oil, hemp seeds and walnuts. You can also take supplements. More research is needed to understand how omega-3 fats might help with inflammation.
Herbal medicines used to reduce inflammation and pain include ginger and turmeric. While there is some evidence that these medicines may help inflammation-based conditions, more studies are needed in this area.
Traditional herbal medicines used for general period pain include cramp bark, black haw and wild yam. But there isn’t enough evidence to suggest these medicines are effective for treating endometriosis-related pain.
A few small studies have explored the use of magnesium supplements to reduce general period pain. The results are promising, but larger studies are needed to confirm the findings.
Smaller studies have found that acupuncture may reduce endometriosis-related pain. But larger, higher-quality trials are needed in this area.
Traditional Chinese medicines may also be recommended for conditions such as endometriosis, but more studies are needed to understand how they work and if they are effective.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
© Jean Hailes Foundation. All rights reserved.
