Lifestyle Changes

Nonsteroidal Anti-inflammatory Drugs (NSAIDs). Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may be sufficient for about 75% of women with endometrial pain. NSAIDs block prostaglandins (the substances that increase uterine contractions). They are effective painkillers and also have other properties that act against inflammatory factors. Aspirin is the most common NSAID, but there are dozens of others available over the counter or by prescription. Among the most effective NSAIDs for menstrual disorders are ibuprofen (Advil, Motrin, Midol PMS), naproxen (Aleve, Naprosyn, Naprelan, Anaprox), and mefenamic acid (Ponstel). For maximum benefit, they should be taken seven to 10 days before a period is expected. It should be noted, however, that long-term use of any NSAID, can increase the risk for gastrointestinal bleeding and ulcers. In fact, one 2001 study of women with iron deficiency anemia reported that overuse of NSAIDs for menstrual disorders contributed to the anemia.

Acetaminophen. One study found that acetaminophen (Tylenol) reduces levels of female hormones (gonadotropins and estradiol, an estrogen), which may have some beneficial effect on menstrual disorders. A combination of acetaminophen and pamabrom (Women's Tylenol Menstrual Relief) is specifically aimed at treating menstrual pain and bloating. (Pamabrom is a diuretic, an agent used to reduce fluid build-up and bloating.)

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Note on Opioids: Drugs containing codeine should not generally be used for endometriosis pain management. They can cause pelvic congestion and constipation, which could exacerbate symptoms in patients with gastrointestinal distress.

Dietary Factors