What is Endometriosis?

Endometriosis is a chronic inflammatory disease that affects women of all ages. It can be difficult to diagnose because the symptoms vary widely from patient to patient and can occur at any stage of a woman's fertile life. Often times, diagnosis is delayed because the patient doesn't recognize the symptoms as abnormal, doctors attribute symptoms to a different condition, or in some cases, the patient doesn't have any symptoms at all.

Pelvic Pain is Not Normal

Endometriosis occurs when the lining of the uterus (the endometrium) is found growing outside of the uterine cavity where it doesn't belong. The endometrium tissue forms cysts called implants that can be found on the ovaries, fallopian tubes, or elsewhere within the abdominal cavity.

This endometrium tissue responds to the hormonal changes of the menstrual cycle, building up and breaking down just like the uterine lining.  With nowhere to go, this tissue isn't able to be expelled and can lead to pain, swelling, irritation, and adhesions surrounding the implants.

Symptoms and Types of Endometriosis

Every woman's experience with endometriosis is unique. It is not uncommon for a woman in stage one to experience extensive pain, while a woman in stage four may be asymptomatic. While endometriosis can be difficult to identify without surgical diagnosis, there are some symptoms that often accompany an endometriosis diagnosis

The most common symptom of endometriosis is pain, which can take the form of extreme menstrual cramps, chronic lower back and pelvic pain, deep set pain during intercourse, or painful bowel movements. Some additional signs that you may be experiencing endometriosis:

•   Bleeding or spotting between menstrual periods

•   Digestive issues

•   Infertility

While these symptoms on their own are not indicative of endometriosis, if you are experiencing one or more of these symptoms, it may be time to reach out for assistance.

Endometriosis and Infertility

Between one-third and one-half of the women who experience endometriosis suffer from fertility issues. Those with mild or moderate endometriosis may still conceive and carry to term, but if the endometriosis affects the fallopian tubes, it may be more difficult to conceive.

What is the Risk of Having Endometriosis During your Lifetime?

Endometriosis affects an estimated 2 to 10 percent of American women of childbearing age. Risk factors for developing endometriosis include:

  • Having never given birth or giving birth for the first time after age 30

  • Family history of endometriosis

  • Starting menstruation at an earlier age

  • Experiencing shorter menstrual cycles (less than 27 days)

  • Having a lower body mass index

  • Having higher estrogen levels in your body

  • Medical condition that reduces a normal menstrual flow

  • Abnormal uterine conditions

Diagnosing Endometriosis

Diagnosing endometriosis begins with visiting a gynecologist. From there, the provider will evaluate symptoms, medical history, and conduct both a physical exam as well as a pelvic exam. Your doctor may also perform an imaging test such as an ultrasound to detect abnormal tissue.

If there is evidence of abnormal activity, your doctor may need to make a definitive diagnosis using a minor surgical procedure known as a laparoscopy, which includes biopsies of endometrial tissue. This combination of procedure and testing can help doctors to understand which stage a woman may be in by identifying the location, size, amount, and the extent of the growth.

Treatments for Endometriosis

While there is no cure for endometriosis, there are treatment options that can help to relieve a patient's symptoms. 

Hormonal Treatments

  1. Hormonal birth control is usually the first step in treatment. This is an excellent place to begin if you are not trying to get pregnant and are not experiencing extreme pain.

  2. Lupron and Orilissa are other hormonal medications which can decrease the painful symptoms.

Surgical Treatments

For patients with severe symptoms or infertility issues, surgery is recommended. Using the minimal-incision laparoscopic method, doctors will remove the excess endometrial tissue from the body, preserving the reproductive organs and creating an increased chance for ongoing fertility.

You and your provider will discuss these options and decided the best plan for you.

Where can I Find More Information on Endometriosis?

For additional information about endometriosis, The American Association of Gynecologic Laparoscopists (AAGL) recommends a website: www.MISforWomen.com and the OB/GYN News publication provides a website: www.endometriosisjourney.com. If you are dealing with endometriosis pain, reach out to the endometriosis specialists at MetroPartners OBGYN today at 651-770-3320.