What You Should Know About Endometriosis

January 25, 2020

Endometriosis effects millions of American women, and is also one of the leading causes of female infertility. While endometriosis can cause significant symptoms in some women – often quite painful symptoms – it exists virtually symptom-free in others.

What is endometriosis?

Your uterus is made up of two very distinct layers: the myometrium and the endometrium. The myometrium is the elastic and muscular layer that grows and expands when you are pregnant. The endometrium is the blood-rich layer that changes in response to your menstrual cycle. It is the layer that will eventually nourish a developing embryo and fetus, and it is the layer that is shed during your period in the months that an egg hasn’t been fertilized.

Endometriosis occurs when the endometrial layer grows outside of the uterus. In most cases, the “extra” endometrial tissue is found on the exterior surface of the uterus, the ovaries, on and around pelvic tissues or on the bowels. In rare cases, it has been found on the lungs, stomach and even in the brain. Endometriosis is most commonly diagnosed in women in their 30s and 40s and disappears altogether during pregnancy and menopause.

It is most likely to occur in women who:

  • Have never had children
  • Have longer than normal periods
  • Have menstrual cycles that average 27 days or less
  • Have a family history of endometriosis
  • Have a low BMI
  • Have other anatomical or health issues that prevent menstrual blood from flowing down and out of the body

What are the symptoms of endometriosis?

As you can imagine, your body isn’t prepared to “shed” endometrial tissue outside the uterus because that tissue isn’t supposed to be there in the first place. So, for most women, the symptoms of endometriosis occur during the days preceding their period – as well as during their period – when the endometrial lining is being flushed from the body. It can irritate surrounding tissues, causing more severe inflammation and discomfort.

Symptoms of endometriosis include:

  • Period cramps that are more painful than normal, often spreading to the lower back
  • Excess bleeding during your period, or bleeding in between periods
  • Pain or severe discomfort during and after sex
  • Pain or discomfort that accompanies urination or bowel movements
  • Difficulty getting pregnant or infertility

The severity of your symptoms does not correlate with the severity of your endometriosis condition. Some women have severe discomfort with only mild endometriosis – this just means the surrounding tissues are more sensitive. Others may have severe endometriosis without any symptoms at all. Only a pelvic exam, ultrasound and/or laparoscopy will determine whether or not you have endometriosis and/or the severity of your particular condition.

Treatments for Endometriosis

Endometriosis doesn’t have a cure, but there are treatments that can provide relief and will help to increase the chances of fertility if endometriosis is considered to be a factor. These include:

Pain medication. If you experience pain or discomfort as a result of endometriosis, your doctor will probably recommend over-the-counter pain medications that have anti-inflammatory properties. If that doesn’t do the trick, you may need more significant treatment.

Hormonal treatments. Sometimes the simple use of hormone-based birth control, like the pill, injectable birth control or an IUD is enough to regulate a woman’s hormone balance and get endometriosis in check. More dramatic examples include Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists or other treatments that prevent menstruation altogether.

Obviously, these are not permanent fixes since you will need to go off these methods when you are ready to conceive and your endometriosis may come back. If your ovaries or other reproductive tissues are affected, this might impact your ability to conceive easily.

Minor surgery. Depending on the severity of your endometriosis, and/or the location of the errant endometrial tissues, your doctor may recommend surgery. In this case, laparoscopic surgery will be performed via a small incision near your navel. Your doctor will remove the endometrial tissue and this can prevent flare-ups in the future.

Full hysterectomy. In very severe cases, especially those in which a woman is no longer interested in having children, your doctor may suggest a full hysterectomy – removing the ovaries, uterus and cervix – to prevent endometrial activity. However, this is a very last resort.

Please feel free to contact Women’s Health Associates if you have questions about endometriosis, or feel you have symptoms of the condition. We’ll be happy to discuss your symptoms, perform a thorough exam and go over your options based on what we find.