• Try to plan ahead so times of high stress do not coincide with your period.

• Accept your limitations and remember you are only human.

• Let your partner, family, friends and employer know about endometriosis and its effects by giving them this leaflet and telling them about the effects it has on you.

There are many different treatments but unfortunately no magical cure. All the treatments work for some women but not others and there is no way of knowing which treatment will for work for you. All the conventional treatments eliminate or alleviate the symptoms in the majority of women but many women will have a recurrence of their symptoms following treatment.

This section gives only a brief introduction to the treatments available. Further information can be found in the resources listed at the end of this fact sheet.

A range of hormonal drugs is used to treat endometriosis. All the drugs aim to suppress the growth of the endometrial implants in some way. None of them are effective in treating endometrial

nodules and endometriomas, which can only be treated surgically. Unfortunately, many women experience side effects when taking them. With the exception of the oral contraceptive pills, all the drugs have much the same effectiveness so the main differences lie in the side effects associated with them. The drugs most commonly used fall into four groups:

• Oral contraceptive pills such as Brevinor, Brevinor–1 and Norinyl–1

• Progesterone-like drugs such as Duphaston, Provera and Depo-Provera

• Androgenic-like drugs such as Danazol and Dimetriose

• GnRH agonists such as Synarel and Zoladex

Surgery aims to alleviate symptoms by removing as much endometriosis as possible. Even though most surgery for endometriosis is done via a laparoscopy it can be quite complex, especially pouch of Douglas surgery.

The treatments able to be performed may be limited by the hospital’s equipment and the surgeon’s skills and experience. Surgery usually involves destroying or removing any endometrial deposits; removing any endometriomas, endometrial nodules and problematic adhesions; and correcting any other abnormalities that may be causing symptoms.

The time you will need to recover varies but generally the more complex the surgery the longer you will need – in general, you should allow yourself one to two weeks before returning to work

or study. Occasionally, a hysterectomy will be needed if all other treatments have failed.

• Make sure you get enough sleep each night, particularly in the week leading up to your period.

• Find an activity that helps you relax: having a bath, reading a book, sending the kids to Grandma’s – whatever it takes.

• Use relaxation techniques such as controlled breathing or visualisation. Take a short course or find a good book on relaxation or meditation.

• Regular, well balanced meals are vital to good health. Avoid sugary foods, fatty foods and caffeine in particular.

• Vitamin, mineral and herbal supplements can be of immense benefit. Try vitamin B6 for fluid retention, bloating and breast tenderness; magnesium for cramps; and zinc and/or iron for fatigue.

• Exercise produces endorphins or ‘happy hormones’. Regular exercise can ‘lift your mood’ and reduce your ‘flat days’ and depression.

• Exercising when in pain can be almost impossible. Try gentle exercise like walking and swimming rather than intense work-outs.

• Try yoga or pilates as an alternative to exercise. They involve gentle stretching and balance exercises which can be quite relaxing.

• Try a heat pack, gentle massage of the painful area or relaxation exercises before using ‘heavy’ painkillers.

• Wherever possible use simple painkillers (such as Panadol and aspirin) or non-steroidal anti-inflammatory medications (such as Ponstan or Naprogesic) to control your pain. Avoid codeine-based painkillers (such as Panadeine Forte) as they cause constipation and can be addictive. Talk to your doctor about suitable pain medications if you cannot maintain adequate pain control.

• Keep a ‘pain diary’. It can be a useful tool to show your doctor. It can also help you to decide if your pain is increasing or decreasing.

• Seek advice about pain management from an alternative health practitioner.

options for a range of women’s health problems. Available from bookstores.

Alternative therapies are used by many women to augment or replace their medical treatment. There are many different therapies and practitioners to choose from so it can be difficult to find the right

therapy and the right practitioner for you. It may help to do some research into the different therapies in order to find the ones you feel most comfortable with. Similarly, you may need to visit several

practitioners before you find one you like and trust. Complementary therapies women have found beneficial for their endometriosis include acupuncture, aromatherapy, Chinese herbs, chiropractic, homeopathy, massage and reflexology.