From the Guidelines
Having flare-ups every week with endometriosis is not typical and suggests that your symptoms may not be adequately managed. While endometriosis pain patterns vary widely between individuals, frequent weekly flares indicate a need for medical evaluation and treatment adjustment, as noted in the most recent guidelines 1. Most patients with well-managed endometriosis experience pain that correlates with their menstrual cycle or occurs less frequently. If you're having weekly flares, consult with your gynecologist or endometriosis specialist promptly.
Treatment Options
Treatment options might include hormonal therapies like combined oral contraceptives, progestins, or GnRH modulators. Pain management approaches may include NSAIDs like ibuprofen or naproxen. Some patients benefit from pelvic floor physical therapy, dietary modifications to reduce inflammation, or surgical interventions depending on the severity and location of endometriosis lesions. The use of imaging before surgery, such as expanded protocol transvaginal ultrasound (TVUS) or MRI, can help inform patient decision making and surgical planning 1.
Importance of Medical Evaluation
Frequent flares occur because endometriosis causes chronic inflammation and tissue irritation, but this inflammation can be reduced with appropriate medical management, potentially decreasing the frequency and severity of your symptoms. The American College of Radiology suggests that a tailored approach to diagnosis and treatment, including the use of imaging and medical therapies, can improve outcomes for patients with endometriosis 1. It is essential to work with a healthcare provider to develop a personalized treatment plan to manage symptoms and improve quality of life. Consulting with a specialist and adjusting treatment as needed can significantly impact morbidity, mortality, and quality of life for individuals with endometriosis.
From the Research
Endometriosis Flare Frequency
- The frequency of endometriosis flares can vary from woman to woman, and there is no specific evidence to suggest that having a flare every week is normal 2.
- Endometriosis is a chronic and inflammatory disease, and its symptoms can be debilitating and unpredictable 2.
- The disease is characterized by the presence of endometrial-like tissue outside the uterus, which can cause painful symptoms, including dysmenorrhea, non-menstrual pelvic pain, and dyspareunia 3, 4.
Factors Influencing Flare Frequency
- Hormonal changes, such as fluctuations in estrogen levels, can contribute to the development of endometriosis symptoms 5.
- Progesterone resistance is a common issue in women with endometriosis, and it can affect the frequency and severity of symptoms 3, 4.
- Other factors, such as stress, inflammation, and oxidative stress, can also play a role in the development of endometriosis symptoms 2, 5.
Management of Endometriosis Symptoms
- Hormonal treatments, such as oral contraceptives, progestogens, and gonadotropin-releasing hormone (GnRH) agonists and antagonists, are commonly used to manage endometriosis symptoms 3, 4, 5.
- These treatments aim to reduce estrogen levels, induce pseudodecidualization, and prevent the progression of endometriotic implants 5.
- Non-pharmacologic approaches, such as surgery and lifestyle modifications, may also be considered as part of a comprehensive treatment plan 2.