What women should know about endometriosis

Endometriosis may be well known but is not always well understood. It is one of the most common gynecological disorders in America, affecting an estimated one in ten women, yet there is a lack of awareness of endometriosis as an important women’s health issue.

About 10 percent of women during their childbearing years will have the condition  of endometriosis.  This sometimes painful problem does not always cause symptoms and is usually not considered to be dangerous.  But it does involve a situation where the type of tissue called endometrium that lines a woman’s uterus, begins to also grow outside of her uterus. This is not considered normal as the tissue will usually grow on the ovaries, fallopian tubes, the outer walls of the uterus, the intestines and other organs located in the abdomen.  This can lead to irritation, pain and the formation of scar tissue or fluid-filled sacs or cysts.

What causes endometriosis?

It is not known what the exact cause of endometriosis is but one theory is called retrograde menstruation.  Normally when a woman has a menstrual cycle, the tissue and blood that naturally accumulates and thickens inside the uterus – the endometrium - in preparation of a baby, will be shed from the body during a monthly period if fertilization does not occur.  In endometriosis, the abnormal endometrial tissue that is residing on other pelvic organs, will act just like normal endometriosis tissue normally found inside the uterus.  But with each menstrual cycle, this abnormal tissue also thickens, breaks down and bleeds causing surrounding tissue to become irritated with possibly scar tissue development.

Other theories include immune system involvement, hormonal issues and there could be a genetic component as endometriosis tends to run in families.

Symptoms of endometriosis

The primary way a woman would know if she has endometriosis is due to pain.  The way pain manifests itself with endometriosis could be by:

·      Painful periods becoming increasingly uncomfortable over time

·      Persistent pain in the lower back or pelvis

·      Pelvic pain during or after sex

·      Painful bowel movement s or urination during menstrual periods

·      Bleeding between periods

·      Unexplained digestive problems such as diarrhea constipation bloating, or upset stomach

Infertility can be another symptom of endometriosis.  Nearly half of all women with the condition will experience infertility.  Most women will find relief from endometriosis once they go through menopause due to the reduced production of estrogen, however some women may continue to have symptoms even after menopause as the body will still produce small amount of the hormone.

Diagnosing endometriosis

There are several tests that can be done to detect if a woman has endometriosis:

·      A pelvic exam

·      An ultrasound exam

·      Laparoscopy

The best way to get a definitive diagnosis is with laparoscopy. During the procedure a laparoscope which has a light and camera will be used to view the organs in the pelvis.  If a sample of tissue appears to be endometriosis, it will be sent to a lab for confirmation of the diagnosis.

Treatment of endometriosis

Treating endometriosis has two main goals which involve reducing and preventing pain and to address infertility problems caused by the condition.

Pain associated with endometriosis can be treated by the following methods:

·      Take an over-the-counter (OTC) pain reliever such as nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen.  If an OTC is not effective in relieving pain, then a prescription pain medication can be another option.

·      Control the amount of estrogen or other hormones fueling the growth of endometrial tissue

·      Regular exercise, limiting alcohol consumption and caffeine can also help reduce estrogen levels

·      Birth-control pills or other hormonal treatments can ease symptoms but if the medications are stopped, the symptoms usually return

·      Surgery can remove areas of endometriosis.  But again, this treatment may be temporary as endometriosis can return with each menstrual cycle

For women experiencing infertility due to endometriosis, surgery to remove tissue in areas of endometriosis can improve the prospect of pregnancy.  Another option to try if surgery is unsuccessful is to try in vitro fertilization.