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Endometriosis Pain Management: What Are the Options?

Pain management is usually a bit of a case of trial and error. What works for some women does not necessarily work for others. Krina Zondervan tells Flo readers what are the possible ways to manage the pain caused by endometriosis. 

How to manage endometriosis pain?

First line treatment typically is NSAIDs (nonsteroidal anti-inflammatory drugs): drugs like ibuprofen, aspirin, et cetera, that you just get over the counter. And for some women, those types of drugs do work to a certain extent. 

The aim of hormonal treatments is to alleviate pain, and that first line of treatment is usually worth trying. 

You could also try to combat chronic pain through making changes in your lifestyle; you can do physical exercises to help pain. It is often helpful to talk to a pain specialist. And those women for whom painkillers and hormones do not really work could go to a tertiary referral center where people are really experienced in treating endometriosis.

The advice there often is to bring in a pain specialist and to say, “OK, this is what you could do to try to help alleviate your pain.” Many women benefit from that.

Do you think that keeping a pain and symptom diary can be helpful to a woman, or to her healthcare provider, for monitoring this condition? For example, in Flo, we give women an opportunity to log their symptoms daily. Can this be helpful?

I think so. 

It is useful for your clinician or physician to know when you typically experience these symptoms. 

Obviously, if it is related to your periods, you will probably know, and you will explain that. 

But if your symptoms happen to be, for example, around ovulation, which is a possibility, then it is often difficult to know exactly when that happens. 

And also simply understanding how regular your periods, for example, are — in some women the evidence is not very strong, but some women have more heavy bleeding with endometriosis. Being able to describe those symptoms clearly to your clinician or physician is important. 

The other side of that coin is that if you really monitor your symptoms very closely, you may start to become very aware of them as well. That might actually impact your life more as well. So there is a potential downside to it. 

So, I would say, yes, it is important to be aware of your symptoms but possibly not get overly concerned, because diagnosis is not established yet. It is also a tool for you to help inform your physician.

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