- What is endometriosis?
- What are the symptoms of endometriosis?
- Is endometriosis treatable?
- Can I prevent endometriosis?
March is Endometriosis Awareness Month, a time when healthcare providers focus increased efforts to get the word out about this debilitating illness, which can be painful and lead to other health problems including infertility. No one knows exactly what causes endometriosis and the condition is notoriously difficult to diagnose.
What is Endometriosis?
Endometriosis comes from the word “endometrium,” which is the lining on the inside of the uterus (womb). Those who struggle with endometriosis experience endometrium that grows outside the womb in other parts of the body. During the normal part of a menstrual cycle, the endometrium builds up waiting for a fertilized egg to plant and grow. If a fertilized egg isn’t implanted, the endometrium sloughs off in the form of a period and the cycle repeats.
However, for those who have endometriosis, the same type of endometrial tissue is present on the other reproductive organs within the pelvis. Every month, that tissue tries to behave in the same way as any endometrium would, by swelling and breaking down. Yet there is nowhere for this tissue outside the uterus to exit the body. This leads to inflammation, pain, swelling, and even scar tissue in the pelvic region.
Endometriosis can affect reproductive health and cause severe pain. The most common places for endometrial tissue to form include:
- Fallopian tubes
- Ligaments that support the uterus
- Outside of the uterus
- Pelvic cavity lining
- The space between the uterus and bladder
- The space between the uterus and rectum
In rare cases, doctors even find endometrial tissue in the bladder, cervix, intestines, rectum, vagina, and vulva.
What Are the Symptoms of Endometriosis?
The number one symptom of endometriosis is pain. This could include:
- Chronic pain in the lower back or pelvis
- Painful menstrual cramps that get worse over time
- Stomach cramping and pain
- Pain during sexual activity
- Problems or pain with urination, especially during your period
Bleeding or spotting between menstrual periods may occur. It’s also common to have digestive problems including bloating, constipation, diarrhea and nausea. What makes endometriosis so difficult to diagnose is that many of these symptoms appear just like other types of illnesses. Everyday Health says it’s typical to live with this pain for up to a decade before the illness is diagnosed. Endometriosis can masquerade as:
- Irritable bowel syndrome (IBS)
- Ovarian cysts
- Pelvic inflammatory disease (PID)
- Urinary tract infections
Since one of the long-term effects of endometriosis is infertility, a misdiagnosis of this condition can be a serious problem.
Is Endometriosis Treatable?
Medications and surgery can treat endometriosis. Sometimes over-the-counter NSAIDs, ibuprofen, or naproxen sodium, as well as heading pads on the abdomen can help with symptoms.
However, the first step is the diagnosis of the disease. A gynecologist may conduct several tests to determine the diagnosis, including:
- A history and complete physical examination
- A pelvic exam
- An ultrasound or MRI to look inside the body
A doctor may also conduct a laparoscopy, which is a surgical procedure that uses a tiny camera to look inside the body. The doctor may also take a biopsy tissue sample if endometrial tissue is detected.
Once the diagnosis is confirmed, the doctor may elect the at-home treatments with non-prescription pain relievers. If simple over-the-counter remedies don’t work, the doctor may prescribe:
- Contraceptives such as birth control pills
- Gonadotropin-releasing hormones (Gn-RH)
- Progestin therapies
- Aromatase inhibitors
The goal of these medications is to regulate the body’s hormones that cause the endometriosis to flare up. If these treatments don’t reduce symptoms, the doctor may discuss the option of surgery to remove the endometrial tissue.
For those who want to become pregnant, a more conservative surgical approach could remove the endometrial tissue without affecting the rest of the reproductive organs. However, many times the ovaries and fallopian tubes are affected by the disease. It just depends on the stage of the disease and the location and amount of the endometrial tissue in the body.
It’s important to know that every person is different. A qualified clinical team will work together to determine the best course of treatment based on:
- How far advanced is the disease
- The symptoms and pain experienced
- The goals and expectations for the course of the disease
- Overall medical history and current state of health
- The tolerance for specific types of medications or surgery
- Whether pregnancy is desired
Once endometriosis is diagnosed, one common question asked is whether pregnancy is possible. Infertility can be a side effect of endometriosis. However, depending on age and condition, pregnancy is possible. About 70% of those with mild to moderate endometriosis can even get pregnant without fertility treatment.
Can I Prevent Endometriosis?
There is no way to totally prevent endometriosis. However, there are a few things that can be done to lessen the risk of getting the disease:
- Avoid alcohol
- Cut down on caffeine
- Exercise regularly
- Lower estrogen by having a doctor prescribe birth control pills, patches or vaginal rings