The pain associated with endometriosis is quite predictable. It is cyclical and usually is worst with ovulation, menstruation or – if women are unlucky (and have unrecognised severe disease) – it may occur for more than three weeks in any four week cycle, as the deposits continue to accumulate and grow.
Endometriosis/severe period pain can be managed by simple oral analgesia once the diagnosis is confirmed. These will suppress the symptoms but not provide a cure. They are useful as bridging agents only, buying time until more effective treatment can be made available.
For acute pain that is genuinely 10/10, intramuscular medications can be administered by a GP or at an Emergency Department where safe monitoring can occur.
For chronic pain, medications that reduce the available oestrogen in the female circulation may be of use too.
However, none of these medications are curative. In the end, excisional surgery (to carefully remove all obvious deposits of endometriosis) remains the best option.