There is no absolute cure for endometriosis and it tends to be an issue that remains with you during most of your fertile years to a greater or lesser extent.

Both medical and surgical treatments give a measure of relief from pain depending on the type of endometriosis you have. The amount of pain relief can vary greatly depending on many factors. Pain can recur after stopping medical treatments or at a later date after surgery.

If you are not keen to have a diagnostic laparoscopy (keyhole surgery) to confirm that you have endometriosis, then it is reasonable to try medical treatments first and then consider a diagnostic laparoscopy later if the medical treatments do not work.

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There are three medical approaches to treatment. The choice is defined by your age, requirement for fertility and the potential side effects of the drugs as all of the hormonal treatments have been shown to be equally effective.

1. Simple pain killers may be used. However most women have already tried these before they see a gynaecologist.
   
   
2. You can take hormones to mimic the hormone levels in pregnancy as we know that endometriosis pain tends to improve during pregnancy. As hormonal contraceptives do mimic pregnancy hormones, they can be used to treat endometriosis. Your doctor may prescribe an oral oestrogen and progesterone combined or progesterone only pill, or a progesterone impregnated coil that fits inside the womb.
   
   
3. You can take hormones to temporarily mimic menopause as we know that endometriosis tends to resolve once menses have stopped. This is generally done by injections that temporarily switch off the ovaries during the treatment period. Your menses will return after the treatment is stopped without risk to your fertility

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Some women wish to proceed directly to a diagnostic laparoscopy because they wish to be certain if they do have endometriosis. Knowing the cause of the problem helps them psychologically to deal with it in many cases.

Surgical treatments for endometriosis are also available, find out more on the next page.

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Ref: S13