You may have heard of a disorder known as endometriosis, whether through a diagnosis of your own or that of a loved one or friend. But what exactly is it? Endometriosis is a common condition that often results in painful periods, pain when having sex, and chronic pain throughout the lower belly. It affects more than 6 million women in the United States but is likely underestimated.
Generally called “endo” for short, it refers to the tissue, known as the endometrium, that typically lines the inside of the uterus. When you have this condition, that tissue actually grows outside of the uterine cavity, often on other parts of the pelvis including the ovaries, fallopian tubes, bladder, and rectum, just to name a few. Over time and if left untreated, the longstanding inflammation that comes from this abnormal growth of tissue can cause internal scarring and even increase your risk of infertility.
Though benign (non-cancerous), endometriosis growths respond and swell as a result of hormones that are produced during your menstrual cycle every month. Just as the lining of the uterus grows and eventually bleeds with every cycle (your menstrual period), the endometriosis glands that make their way outside of the uterus also bleed. This bleeding can cause inflammation and intense pain during your menstrual cycle, and over time can result in permanent scarring. Over time, this scarring can affect your bladder, gastrointestinal system, and fallopian tubes, resulting in infertility.
Most cases of endometriosis are diagnosed in women in their 20s and 30s, predominately during their reproductive years. Other risk factors include never having children, frequent menstrual cycles occurring less than 27 days apart, long cycles lasting more than seven days, a family history of endometriosis, and structural problems of the uterus that may prevent the normal flow of menstrual blood during your cycle.
Diagnosing the condition can be done based on your history of symptoms, through a thorough pelvic examination, and by gauging a response to treatments, especially hormonal birth control and gonadotropin-releasing hormone agents (GnRH). A definitive diagnosis of endometriosis is obtained using laparoscopic surgery to visually inspect the abdomen for any endometriosis growths or scarring. However, most patients will often not require surgery and symptom improvement alone with standard treatments allow your gynecologist to presume a diagnosis of endometriosis without you undergoing the risks of surgery. Surgery for diagnosis is often performed when patients have failed multiple medicines to help with their pain. If endometriosis is confirmed during surgery, the lesions can then often be burned or excised at the time of surgery.
Treatment Options for Endometriosis
While it is unknown what exactly causes endometriosis and there is no actual cure for the condition, the good news is there are many treatments that have been found to be effective in treating the symptoms, including pain and infertility. A few treatment options may include:
- Over-the-counter anti-inflammatory pain medications such as ibuprofen
- Hormonal birth control
- Gonadotropin-releasing hormone agents (GnRH)
- Minimally invasive surgery
If you believe you may have signs or symptoms of endometriosis, speak with your doctor about what treatment options may be right for you.