What is Endometriosis?
Endometriosis is a disorder of the female reproductive system which occurs in reproductive-aged women. The lining of the uterus is called the endometrium or endometrial tissue. When endometriosis is present, tissue which normally lines the inside of the uterus, grows outside of the uterus. This condition usually involves ovaries, fallopian tubes, and the lining of the pelvis. In rare cases, the endometrial tissue may spread beyond the pelvic organs and involve old surgical scars, the intestine, the bladder, or the appendix. Because endometriosis creates inflammation, it can lead to the formation of fibrous bands of tissue (adhesions) which can cause pelvic tissues and organs to stick to one another.
Endometriosis treatment is available and can relieve such symptoms as severe cramping, unusually heavy bleeding, and pelvic pain, to name a few. Give us a call today to schedule an appointment to learn more about your options.
There are no exact signs or symptoms of endometriosis, and many of the symptoms associated with it can also be associated with other health problems such as pelvic inflammatory disease (PID), ovarian cysts, irritable bowel syndrome (IBS), or interstitial cystitis (painful bladder syndrome). Although some women with endometriosis have no symptoms, most have pain in the lower part of the belly or pelvis, often associated with menstruation. While many women experience cramping during their periods, those with endometriosis frequently describe menstrual pain that is severe, and which interferes with their day to day life. This pain may increase over time, and become less connected to the time of the woman’s menstrual flow.
If you are experiencing any of the following on a regular or recurrent basis, we encourage you to consult with your physician as they could be signs/symptoms of endometriosis:
- Severe cramping or pain before and/or during your period
- Uterine or pelvic pain
- Pain in your lower abdomen, low back, or rectum
- Pain with intercourse
- Unusually heavy bleeding
- Spotting or bleeding between menstrual cycles
- Pain with urination or bowel movements during your menstrual cycle
Endometriosis can also lead to problems getting pregnant (infertility) and create growths on the ovaries called endometriomas (or chocolate cysts) which can be felt by a doctor during an exam or seen on ultrasound.
Causes of Endometriosis
Although doctors and researchers do not know the exact cause of this condition, genetics plays a part as does your body’s response to certain hormones such as estrogen and progesterone. The Mayo Clinic lists several possible explanations, including:
- Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
- Transformation of peritoneal cells. In what’s known as the “induction theory,” experts propose that hormones or immune factors promote transformation of peritoneal cells—cells that line the inner side of your abdomen—into endometrial-like cells.
- Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells—cells in the earliest stages of development—into endometrial-like cell implants during puberty.
- Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
- Endometrial cell transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
- Immune system disorder. A problem with the immune system may make the body unable to recognize and destroy endometrial-like tissue that’s growing outside the uterus.
Diagnosis of Endometriosis
There is no test for endometriosis at this time, but it can be suspected based on symptoms and by doing an exam. The only way to diagnose it is by doing a minor surgery called a laparoscopy. During a laparoscopy, a physician can look for the presence of endometriosis tissue. They can also biopsy any areas they have questions about, remove or destroy any visible endometriosis, and release scar tissue (adhesions).
If you think you might be experiencing endometriosis symptoms,
please contact our team of healthcare professionals.
There are many effective treatments available depending on your endometriosis symptoms and whether you want to get pregnant in the future.
- Pain medication: used to treat the pain (for example, pelvic pain, cramping, etc.) caused by endometriosis but does not make the endometriosis go away
- Birth control hormones: most types of hormonal birth control can be used to treat endometriosis pain and to discourage endometriosis from growing. They do this by changing the hormone environment in the body to one that discourages the stimulation and growth of the endometriosis cells. The birth control pill, the birth control shot and the hormone containing IUD’s are most commonly used for this purpose.
- Medication that stops monthly periods: these medications temporarily stop the body from producing certain hormones that cause endometriosis to grow, similar to menopause. They can be very effective if birth control therapy has not worked. A woman cannot get pregnant while taking these medications.
- Laparoscopy: through a small incision in the belly, a camera is placed. Any visible endometriosis can then be removed or destroyed. If scar tissue is present, it can also be released, and normal anatomy restored.
- Hysterectomy: for women who have finished childbearing, and if other treatments have not worked, hysterectomy is an option. This involves surgery to remove the uterus. Sometimes the ovaries will also be removed if they are heavily involved with endometriosis.
- Pregnancy: pregnancy is very effective at suppressing endometriosis. This is because the high level of certain hormones in pregnancy causes the endometriosis tissue to become dormant. Nursing after pregnancy will further delay the return of endometriosis symptoms. Some women will opt to start a pregnancy rather than take medication to treat their endometriosis.
Endometriosis can be challenging to manage, but it is a treatable medical condition that, once remedied, can increase your enjoyment of life and improve your overall health and wellness. An early diagnosis and proper treatment of your endometriosis may result in better management of your symptoms.
About Associates in Women’s Health
The staff at Associates in Women’s Health is committed to providing you with a lifetime of care to meet your changing needs. We are a small, caring group whose goal is to give you the kind of personalized obstetric and gynecologic care you desire in a comfortable and intimate setting. Our state-of-the-art technology and the kind of attention to detail that only a small practice can provide, combine to offer you exceptional one-on-one healthcare you won’t find anywhere else.