There are several principles governing the treatment of chronic pelvic pain and endometriosis. It is important to be clear about what has caused your symptoms and what your treatment is attempting to achieve. It may be reasonable to combine different forms of treatment to try and ameliorate your symptoms. Alternative treatments may be helpful depending on your individual circumstances
Principle 1
Direct pain relief e.g, aspirin, mefenamic acid, codeine, etc
Principle 2
Reduce pelvic blood flow e.g. progesterone, GnRH agonists, aromatase inhibitors, or in the worst case, bilateral oophoerectomy (removal of both ovaries) etc
Principle 3
Prevent pain from abnormal nerves in the affected organ e.g. TENS, acupuncture, etc
Principle 4
Remove the burden of abnormal nerves and blood vessels e.g. hysterectomy with, or without oophorectomy, etc
Principle 5
Prevent interpretation of signals as pain e.g. tricyclic antidepressants, SSRI’s, etc
Principle 6
Maintain your mood and well-being as best you can. Painful pelvic symptoms can be much worse when your mood is low. Much may be gained by understanding where this pain comes from and what affects it.