Endometriosis is a chronic and often painful medical condition that occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus. Normally, the endometrial tissue thickens and sheds during the menstrual cycle, leading to menstruation. However, in individuals with endometriosis, this tissue can grow in other areas of the pelvic cavity, such as on the ovaries, fallopian tubes, the outer surface of the uterus, the bowel, and the lining of the pelvis.

If you are suffering with endometriosis pain, you should see a pain specialist.

How is pain managed:

Endometriosis pain management can be complex and often requires a multi-faceted approach tailored to the individual's specific symptoms and needs. Pain specialists play a crucial role in managing endometriosis-associated pain, particularly when the condition leads to chronic and debilitating discomfort.

Non-pharmacological pain management:

Heat therapy: Applying a heating pad or warm compress to the lower abdomen can help alleviate menstrual cramps and pelvic pain.

Pelvic floor physical therapy: Specialised physical therapy can help improve pelvic muscle function, reduce pain, and enhance overall pelvic health.

Stress reduction techniques: Techniques such as yoga, meditation, and deep breathing exercises can help manage stress, which may exacerbate pain perception.

Pharmacological pain management:

Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen or prescription-strength NSAIDs can help reduce pain and inflammation associated with endometriosis.

Hormonal medications: Hormonal therapies, such as birth control pills, progestin-only options, and GnRH agonists, may be prescribed to regulate the menstrual cycle, reduce oestrogen levels, and manage pain.

Pain medications: In some cases, stronger pain medications or opioids may be prescribed for severe pain, but their use is generally limited due to the risk of dependence.

Surgical interventions:

Laparoscopic excision surgery: This minimally invasive surgery aims to remove endometrial lesions and adhesions, providing long-term pain relief for many individuals with endometriosis.

Hysterectomy: In severe cases or when fertility is not a concern, a hysterectomy (removal of the uterus) may be recommended. This is often combined with removal of the ovaries (oophorectomy) to eliminate the main source of oestrogen production.

Complementary and alternative therapies: Pain specialists may recommend complementary therapies like acupuncture, herbal supplements, or dietary modifications to help manage endometriosis pain. However, these should be used with caution and under the guidance of a healthcare provider.

Psychological support: Pain specialists and mental health professionals can work together to address the emotional impact of chronic pain. Counselling, support groups, and cognitive-behavioural therapy can help individuals cope with the psychological aspects of endometriosis pain.

The role of pain specialists:

Pain specialists, such as pain management physicians or anaesthesiologists with expertise in pain management, play a vital role in the comprehensive care of individuals with endometriosis-related pain. Their role includes:

Pain assessment: Pain specialists can perform a detailed assessment to evaluate the nature, severity, and impact of endometriosis-related pain on an individual's daily life.

Treatment planning: They collaborate with gynaecologists and other healthcare providers to develop a personalised pain management plan tailored to the individual's needs, which may include medication management, interventional procedures, or referral for surgery.

Interventional procedures: Pain specialists may perform interventional procedures, such as nerve blocks or epidural injections, to target and alleviate specific sources of pain.

Medication management: They can prescribe and manage medications to address pain, ensuring that the chosen medications are safe and effective for the individual.

Coordination of care: Pain specialists often work as part of a multidisciplinary team, coordinating care with gynaecologists, physical therapists, and mental health professionals to provide comprehensive pain management.