Painkillers and Endometriosis

One of the major symptoms of endometriosis that women have to deal with is pain. For many, this pain becomes so unbearable that it can alter their life and make it a living hell. However, when you have endometriosis, it is best to face the problem head on and, instead of pain altering your life, do everything possible to eradicate or suppress it.

Pain Management

The most common and prescribed way to treat the pain associated with endometriosis is the use of painkillers. Though pain medications do not help in eradicating the disease, they do provide a relief from the constant ache. Other options that can help you cope with the pain are natural remedies, dietary changes or supplements. If you are taking pain medicines, it is best to start them as soon as symptoms begin, if it doesn’t feel “that bad” just yet.

Types of Painkillers

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
This class of drugs act in two ways: they reduce pain and have anti-inflammatory properties. In women suffering from endometriosis, prostaglandins are the inflammatory factors, which increase uterine contraction and cause pain. NSAIDs help block these prostaglandins and thereby suppress the pain.

There are many over-the-counter drugs available that have been known to provide good pain relief for a long time. Women suffering from endometriosis can benefit from the use of NSAIDs, such as ibuprofen, to cope with their abdominal pain or other aches. Most chemists sell a variety of over-the-counter NSAID medications. Prescription NSAIDs, which have the same chemical makeup but are stronger, are also available for women with exceptional endometriosis pain.

Some pain killers may contain codeine, which may not be ideal for those suffering from endometriosis. Because codeine can cause constipation and pelvic congestion, use of these drugs may actually worsen your symptoms. Make sure you discuss your use of pain killers with your doctor first so you can avoid using the wrong type of medication.

GnRH Agonists
In recent times, gonadotropin releasing hormones have become a popular way of relieving endometriosis associated pain. These usually act by decreasing the brain�s production of lutinising and follicle stimulating hormones, which are responsible for the release of estrogens. They can be administered either through the use of a nasal spray or through monthly injections and take about a month to become effective.

In a woman’s body, production of oestrogen helps encourage the maturation of the egg follicles as well as thickens the endometrial lining. Therefore, when oestrogen is not released, the endometrial tissue inside or outside the uterus does not thicken, thereby causing no irritation to the organs.

GnRH agonists can help women suffering from endometriosis in two ways. They reduce the lower abdominal or period pain and also help in shrinking the endometrial tissue at different locations, as it does not get sufficient hormonal supplement for growth. Nevertheless, this shrinking is only temporary and for a permanent removal, it is always better to opt for laparoscopy.

Usually doctors prescribe this kind of pain relief medication for no more than six months, as a major side effect is loss of bone mass. Sometimes the doctor may also stop the treatment midway to allow for recovery time or may give an additional hormonal therapy treatment called add back therapy to eradicate the problem of the bones.

Menstrual Period Inhibiting Drugs
Drugs or hormones, like progesterone, that are usually taken to stop menstrual periods have also been known to suppress the symptoms of endometriosis. However, the dosage taken has to be higher and thus there are many side effects associated with these drugs, like weight gain, depression, vaginal bleeding or some prolonged effects on the ovaries.

Opioids
Opioids, derived from the opium poppy plant or manufactured artificially, help relieve pain by blocking pain signals in your body. There are various types of opioids including morphine, codeine, oxycodone, and methadone. However, one has to be very careful while taking these drugs, as you can easily get addicted to their use. Doctors usually recommend rotating the type of opiate you take as pain pills so that you do not get too tolerant to one particular drug.

New Options
Research in the field of pain medication for endometriosis has lead to the discovery of two new options that can be used to manage pain.

A group of researchers in Italy have found that if someone suffering from endometriosis takes oral contraceptives continuously, not stopping for a pill-free or placebo pill week , then endometrial pain is significantly reduced. This is a good option for those who are not planning a pregnancy. Once you stop taking these pills, your normal fertility and cycle is restored in a few months time thereby causing no prolonged effect. You may also want to consider using a birth control pill that is taken continuously for three months and allows for a period just four times a year. Talk with your doctor to see if continuous birth control pill use is a good option for you.

Another new drug capable of suppressing the pain is the aromatase inhibitor, normally used for the treatment of breast cancer in women. In studies of premenopausal women with painful endometriosis that had not been helped by other treatments, researchers found that using an aromatase inhibitor, in this case Femara (letrozole), significantly improved the pain symptoms in all of the women.

Side Effects

All painkillers used for endometriosis pain have some minor or major side effects associated with them. Some are addictive while others, like hormonal medications, can cause weight gain, nausea, depression, vomiting, dizziness, and irregular vaginal bleeding. In some instances, these medications can also have negative consequences on other areas of the body, such as the bones, liver, and ovaries.

If you are considering taking pain medication for your endometrial discomfort, take the time to thoroughly discuss the subject with your prescribing doctor. Make sure you are aware of all the risk and possible side effects of the medication so that you can make an informed decision as to whether this treatment is right for you.