Endometriosis

 Endometriosis

Endometriosis occurs when the endometrial lining of the uterus attaches itself to other organs outside of the uterus. During menstruation, the endometrial lining is shed from the uterus, but the lining that has attached outside the uterus has no way of leaving the body. This lining continues to be aggravated at the times of ovulation and menstruation and can break down and bleed, tear away, or form painful scar tissue. These implants or lesions grow abnormally leading to pain and discomfort. According to the Endometriosis Research Center, this disease affects more than 7 million women in the US and is the leading cause of female infertility, chronic pelvic pain, and gynecologic surgeries.

What causes endometriosis?

There is no known cause for endometriosis. Some experts have come up with a few possibilities, but nothing has been conclusively proven.

One possible cause of endometriosis is that during menstruation, menstrual tissue backs up into the fallopian tubes, enters the abdominal cavity, and implants. Most physicians believe that all women experience some type of back up at some point, but women who have immune problems go on to develop endometriosis.

Another theory is that endometriosis is a genetic birth abnormality in which the endometrial cells develop outside of the uterus during fetal development. Once this female is grown and begins to experience menstruation, these misplaced cells become lesions or implants that cause pain and discomfort.

There is also a genetic theory that is being studied worldwide by doctors based in London. This theory bases strong evidence on the idea that endometriosis is hereditary. Early studies show that women with a family history of endometriosis are more likely to have daughters who suffer from the disease.

What are the symptoms of endometriosis?

Symptoms of endometriosis may include one or more of the following:

  • Chronic or intermittent pelvic pain
  • Dysmenorrhea (painful menstruation)
  • Infertility
  • Painful sexual intercourse
  • Painful bowel movements
  • Fatigue
  • Heavy or irregular bleeding
  • Pain during ovulation
  • Gastrointestinal problems (constipation, diarrhea, bloating)
  • Painful urination
  • Lower back pain

How is endometriosis diagnosed?

Endometriosis can only be diagnosed through surgery. Ultrasounds, MRIs, and CAT scans are not conclusive when diagnosing endometriosis. A physician will usually study the history of symptoms and decide whether a surgical procedure is needed to make a diagnosis. A laparoscopy or laparotomy procedure is used when trying to diagnose endometriosis.

Is there a cure for endometriosis?

There is not a cure for endometriosis, but there is treatment to help women manage and deal with their symptoms.

What is the treatment for endometriosis?

The treatment of endometriosis can be handled in one or more of four ways:

Pain Medication: Some over-the-counter pain medications such as aspirin, acetaminophen, and ibuprofen may lessen the discomfort for women when dealing with endometriosis. Prescription medication may be needed if the pain does not respond to over-the-counter drugs.

Hormonal Drug Therapy: Hormonal drugs are given to try to stop ovulation for as long as possible in order to keep the implants or lesions from being aggravated. These can include oral contraceptives, progesterone drugs, and GnRH agonists. Most of these therapies can only be given for a limited amount of time, and the side effects can cause problems for some women. Hormonal drug therapy is used to ward off symptoms and is often most effective when used after surgical treatment has been done.

Surgery: Conservative surgery is used to diagnose, remove growths, relieve pain, and increase the chances of pregnancy. Conservative surgery is usually done through a laparoscopy or a laparotomy. In some cases, a more radical surgery such as a hysterectomy is recommended for treating endometriosis.

Alternative or Natural Therapy: Some women have found different types of natural remedies to use when dealing with endometriosis. Remedies such as vitamins and herbs, diet changes, acupuncture, myofascial release and Chinese medicine have proven to be useful therapies when managing endometriosis. Talk with a certified dietician, acupuncturist, physical therapist or homeopathic physician on alternative ways to deal with symptoms of endometriosis.

FAQ’s about endometriosis:

Does pregnancy cure endometriosis? There is no cure for endometriosis, but for some women pregnancy can lessen the symptoms and effects.

If I have a hysterectomy, will that make my endometriosis go away? A hysterectomy is not the cure for endometriosis, but it can make a difference for some women. Discuss all of your options with your doctor before choosing to have a hysterectomy.

How can I prevent endometriosis? There is no known prevention at this time. Researchers have not discovered a conclusive reason why women get endometriosis, therefore they do not have a way to prevent it from occurring.

Where are endometriosis lesions found? The most common areas for endometriosis to implant are on the ovaries, the outside wall of the uterus, fallopian tubes, pelvic cavity, and reproductive organ ligaments. Lesions can also be found on the bladder, bowel, cervix, vagina, and abdominal surgery scars.

I have all the symptoms of endometriosis, but my doctor said that I do not have it… could he be wrong, or is this all in my head? Yes, your doctor could be wrong, and NO, it is not in your head! Endometriosis is one of the most misunderstood diseases in women’s health. This does not mean that your doctor is not a good physician, but with any disease, a specialist is the best at making a conclusive diagnosis. The average amount of time it takes for a woman to get an accurate diagnosis from the onset of symptoms is about 10 years. This is due to the lack of research and information getting to doctors and the fact that endometriosis can mimic many other diseases and disorders. The best thing is to seek out an endometriosis specialist and let him/her confirm the possibility of endometriosis.

If I have been diagnosed with endometriosis, does that mean I cannot get pregnant? Endometriosis can cause infertility in many women, but with proactive treatment, the possibility of pregnancy is increased. Discuss treatment options with your doctor to decide what would be the best course to take to increase your chances of pregnancy.

Last Updated: 05/2013

Compiled using information from the following sources:

Endometriosis Association, www.endometriosisassn.org

Endometriosis Research Center, www.endocenter.org