Endometriosis is a painful – sometimes debilitating condition that affects millions of women worldwide. Estimates suggest that nearly 1 in 10 women will develop endometriosis during her childbearing years; nevertheless endometriosis remains a largely underdiagnosed and ineffectively treated condition.
What is endometriosis?
Each month during a normal period, the inner lining of the uterus (endometrium) naturally sheds. Endometriosis develops when some of this endometrial tissue begins to grow around surrounding pelvic structures such as the ovaries, bowel or intestines.
This displaced tissue still responds to the natural hormonal commands of the body – growing, thickening and bleeding – during each menstrual cycle. However, the displaced tissue has no way to exit and becomes trapped within the body. This process leads to internal bleeding and subsequently abnormal scar tissue and adhesions (bands of dense tissue) that can bind or twist organs together.
Symptoms of endometriosis include pelvic pain – especially during a woman’s period (dysmenorrhea), excessive bleeding, pain during intercourse, pain during bowl movements or urination and infertility.
Who gets endometriosis?
The exact cause of endometriosis is not well understood. However, certain factors can increase risks including family history, a shorter than normal menstrual cycle (less than 27 days and more than eight days of bleeding), any medical condition that restricts normal menstrual flow, or a history of a pelvic infection. Endometriosis is also far more common in women who have never given birth.
How can I get tested for endometriosis?
A pelvic exam or ultrasound can be useful when symptoms of endometriosis are present. But the only way to establish an accurate diagnosis is through a laparoscopy. A laparoscopy is a minor surgical procedure that allows a physician/surgeon to look inside of the abdomen and visually identify endometrial tissue. During a laparoscopy, a small tissue sample (biopsy) is removed and examined to establish an official diagnosis.
Does endometriosis affect fertility?
Infertility – an inability to have children – is a complication associated with endometriosis. Approximately 30-40 percent of women with endometriosis are unable to have children due to excessive reproductive scar tissue.
How is endometriosis treated?
There is no medical cure for endometriosis, but symptoms can be effectively managed with medical or surgical intervention, if needed. For pain relief, over-the-counter medications such as ibuprofen are often recommended to minimize menstrual cramps.
Hormonal treatments such as birth control pills, patches or vaginal rings can be used to reduce the amount of endometrial tissue that builds up during a normal cycle each month. If normal birth control doesn’t work, stronger hormonal therapies such as gonadotropin-releasing hormone agonists, progestin, danazol or aromatase inhibitors may be used to manage unpleasant symptoms.
If hormonal treatments are unsuccessful, surgery can be used to cut away or destroy endometrial growths (endometrial ablation). In more severe cases, surgery to remove the uterus (hysterectomy) or both ovaries (bilateral oophorectomy) can be performed. These procedures will induce early menopause and should not be performed if you plan to become pregnant in the future.