Reviewed by: HU Medical Review Board | Last reviewed: March 2023 | Last updated: April 2023
Chronic pain often accompanies endometriosis. This pain can come with a person's period (dysmenorrhea) or with sex (dyspareunia). However, it may be present all the time and without an obvious pattern or trend. Pain medicines can offer much-needed relief. Managing the pain that often comes with endometriosis may also improve quality of life.
Nonsteroidal anti-inflammatory (NSAIDs) are common medicines used to treat endometriosis pain. Opioids are another class of pain medicine. However, they are not recommended to treat endometriosis pain.
NSAIDs are a large class of drugs used to relieve pain caused by many conditions. NSAIDs are often used as a first-line treatment for generalized pain, headaches, and inflammation. NSAIDs are also used as fever-reducers.
Some NSAIDs are available over-the-counter (OTC). This includes aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve). Other NSAIDs, as well as higher doses of OTC NSAIDs, may be available by prescription only.
While NSAIDs can be used to treat pain long-term, they come with several risks. Side effects may include:
- Gastrointestinal bleeding
- Increased risk of heart attack or stroke
- Skin issues such as bruising, bleeding, or rash
- Allergic reactions
These are not all the possible side effects of NSAIDs. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with NSAIDs.
NSAIDs work by blocking enzymes that are involved in the production of prostaglandins. Prostaglandins play a role in the inflammatory and pain response pathways in the body. By reducing or blocking the formation of prostaglandin, NSAIDs are able to reduce inflammation and pain.1,2
Opioids are a class of drugs that act on the opioid receptors within the body. These receptors are mainly in the brain and spinal cord. However, they can be in other parts of the body, including the digestive and respiratory tracts.
Some opioids are available via prescription. This includes:
- Hydrocodone/acetaminophen (Vicodin)
- Oxycodone ER (Oxycontin)
- Oxycodone/acetaminophen (Percocet)
Opioids are designed to mimic the effects of opium. Opium is a substance derived from the opium poppy plant. Like opium, opioids have pain-relieving properties. Prescription opioids are often used after surgical procedures or for serious injuries that cause acute (short-term) pain. Opioids also affect other receptors in the body that impact our emotions, including those that control pleasure. Because of this, opioids can become addictive.3,4
In recent years, the number of opioid prescriptions has dramatically increased. This has helped pave the way for their widespread use. This increased availability of opioids and their potential for misuse by those trying to achieve euphoria or "get high" has led to the current "opioid crisis" or "opioid epidemic" that dominates the news today. To combat the opioid crisis and prevent more people from becoming addicted to these drugs, doctors are encouraged to only prescribe opioids when absolutely necessary and closely monitor those taking them. Following this trend, prescribing opioids for the treatment of chronic (long-term) pain, like in the case of endometriosis, has become discouraged.3,4
Other methods of pain relief
If pain medicines are not helping your symptoms, you may want to try alternative options before pursuing more invasive treatments. Some of these include the use of heat or heating pads, exercise, yoga, changes in diet, acupuncture, chiropractic care, and mind-body practices.