As with the work up of any medical condition, the important thing is to rule out dangerous problems first, then focus on treating the symptoms. If your doctor has performed appropriate testing and found no specific cause, she may need to experiment with more than one treatment regime to find out what works best for your body to regulate your periods. Often the treatment will involve oral contraception or some other use of estrogen and progesterone to regulate the periods. Rarely it can become necessary to perform a hysterectomy if heavy periods have failed to respond to hormone therapy and the bleeding has lead to severe anemia, or if precancerous or cancerous conditions of the uterine lining exist. A friend of mine has just been diagnosed with endometriosis.
Symptoms can include painful menses, pain on intercourse, and infertility.
The infertility is usually caused by endometrial tissue which scars the fallopian tubes. Treatment modalities include oral contraceptives, progestins alone, danazol and gonadotropin releasing hormones. These drugs all suppress the cyclic growth of the endometrial tissue in some way. Endometriosis can sometimes be surgically corrected by cauterizing and or removing the endometrial tissue and scarring due to the implants. This approach may be used to attempt to restore fertility if infertility has become a problem.