Treating endometriosis is not straightforward, and it often requires an individual approach. Treatment options can generally be divided into hormonal therapy, surgical treatment, and managing symptoms in daily life.
In this post, I also share my honest personal experience with hormonal treatment.
Hormonal treatment
The primary treatment for endometriosis is hormonal. The goal is to prevent or slow the progression of the disease through hormonal medication.
Common options include:
- birth control pills
- hormonal IUD (coil)
- contraceptive implants
There is no strong evidence that hormonal treatment stops the progression of the disease. Its main purpose is to manage symptoms, and for some people, it can significantly help with pain and heavy bleeding.
Surgical treatment
If symptoms significantly affect quality of life, endometriosis can be treated surgically.
During laparoscopic surgery, endometriosis tissue and endometriomas (blood-filled cysts) are removed. Because this misplaced tissue causes chronic inflammation and pain, removing it often provides significant relief.
If symptoms keep recurring despite surgery, more radical procedures – such as removing the uterus or damaged organs – may be considered in some cases.
My experience with hormonal treatment
I was first prescribed birth control pills in my early teens by a school nurse.
My teenage years were extremely difficult. I struggled with daily life and relationships, and I was diagnosed with severe depression. Looking back, I’ve wondered whether some of those symptoms were connected to the hormonal contraception I used for years.
I’ve never fully understood why hormonal contraception is prescribed so lightly to young people. In my opinion, condoms should be the primary method – they prevent both pregnancy and sexually transmitted infections.
Trying again later – same result
A few years later, I tried hormonal contraception again while in a relationship. I tested both combination pills and the vaginal ring.
My personality changed so drastically that my partner asked me to stop. I experienced:
- constant crying
- irritability and conflict-seeking
- sudden anger
- suicidal thoughts
Although doctors often recommend continuing for 3–6 months to allow the body to adjust, my symptoms were too severe. I decided I would never use hormones again.
The diagnosis changed everything
I was diagnosed with endometriosis in 2022.
Once again, hormonal treatment was recommended. I refused due to mental health concerns. However, after surgery in 2023, I was strongly encouraged to start treatment.
I began with mini-pills, and the first month went well. After that, a Mirena hormonal IUD was inserted.
When everything collapsed
Over the following months, all the psychological symptoms I had experienced before returned – stronger than ever. In January 2024, I was diagnosed with bipolar disorder.
I had previously experienced mood swings – depression in winter, high energy in summer – but only then did the full picture start to make sense.
I was prescribed mood-stabilizing medication, which helped temporarily.
When your body says stop
During spring, the symptoms started to return again. I tried to raise concerns about whether hormonal treatment could worsen bipolar symptoms. The suggested solution was to increase the dose of mood stabilizers.
At that point, I knew something wasn’t right. I had told my psychiatrist that I was constantly ending up in conflicts due to my condition – and somewhat ironically, our treatment relationship ended in conflict during that visit.
I went to a gynecologist and asked to have the IUD removed, even if it meant my endometriosis might worsen.
About five days after removal:
- I felt lighter
- the world felt brighter again
- my motivation returned
Physical symptoms also improved:
- uterine pain decreased
- cramping stopped
My decision
After this experience, I made a clear decision: I will not use hormonal long-term treatment again – even under medical pressure.
My personal view is that hormonal contraception is often prescribed too easily, without fully understanding its impact on mental health. For those with mental health challenges, it can be a risk that shouldn’t be underestimated.
What about treatment without hormones?
Since hormonal treatment is not an option for me, the main treatment is surgery when symptoms worsen.
In addition, I focus on managing symptoms in everyday life:
- supplements (such as NAC, omega-3, magnesium, *ad links)
- an anti-inflammatory diet
- exercise and body care
- heat (heating pads, baths)
- pain relief medication
Final thoughts
Endometriosis is a complex condition, and there is no single “correct” treatment path.
For those of us who cannot tolerate hormones, the options are more limited. That’s why it’s important to listen to your body, question things, and find solutions that truly support your well-being.
No one should have to live with constant pain or discomfort – whether physical or mental.
