You have options for different types of medications to ease endometriosis pain. Although they won’t cure the condition, they may help you feel better. Some need a prescription. Others you can buy “over the counter.” Your doctor may recommend that you try more than one kind.
If your symptoms are mild, your doctor will likely suggest you take a pain reliever. These may include NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen.
Sometimes endometriosis pain can be severe. So, if you try pain meds that you can buy without a prescription and you don’t get enough relief, your doctor will consider whether you need a prescription for a stronger type of medicine.
This type of treatment may be a good choice if pain medicines don’t help enough. Doctors can prescribe medicines that cut down on how much estrogen your body makes. There are also hormonal meds that can prevent your menstrual period and make areas affected by endometriosis bleed less. That cuts down on inflammation and makes scars and ovarian cysts less likely.
The most common hormones that doctors prescribe for endometriosis include:
Birth control pills, patches, and vaginal rings. These contraceptives include both estrogen and progestin.
Meds that affect gonadotropin-releasing hormone (GnRH). You take them either as a nasal spray, shot, or pill. Doctors usually recommend limiting their use to 12 months at a time because of side effects that could affect your heart and bones. Your doctor may call these GnRH agonists, analogues, or antagonists:
- Elagolix (Orilissa) -- Oral tablet taken twice daily
- Goserelin (Zoladex) -- Shot taken once every 28 days
- Leuprolide (Lupron) -- Shot taken once every 1 or 3 months
- Nafarelin (Synarel) -- Nasal spray taken twice per day
Doctors limit the number of months these meds are taken because of bone density loss that can increase the risk of fractures.
Progestin-only contraceptives. These include pills, shots, and an IUD (intrauterine device). These medicines can cut down on pain, as most women don’t have a period while taking these medicines, or at least have fewer periods.
Danazol (Danocrine). This medicine stops your body from releasing hormones that it uses to help bring about your period. You need to be on birth control while you take it to prevent pregnancy. If you get pregnant while taking danazol, it could cause a female baby to have male traits.
Hormone therapy can cause side effects such as weight gain, depression, acne, body hair, and irregular bleeding. You should talk with your doctor about the risks and benefits. Also, if you stop taking this type of medicine, your symptoms may come back. Tell your doctor if that happens.
Aromatase is a chemical that boosts your body’s estrogen production. Aromatase inhibitors block it, which lowers your estrogen level. These medicines aren’t routinely used to treat endometriosis. But in some cases, doctors recommend it "off label" in addition to hormonal therapy to manage endometriosis pain, as long as you aren’t planning to get pregnant while on this treatment.