Endometriosis is a common and often painful condition that affects roughly 1 out of 10
women and gender diverse individuals who are 25 to 40 years old. Today we're going to talk about
the following questions: I'm going to explain what endometriosis is, discuss the common causes and
symptoms, and review diagnosis and treatment.
What is endometriosis?
The endometrium refers to the cells that line the inside of the uterus during a menstrual cycle.
The endometrium is stimulated by hormones and grows finally shedding with the period at the end of every month.
Endometriosis happens when the cells that usually line the inside of the uterus grow outside the uterus.
Usually this happens in the pelvis near the uterus ovaries and fallopian tubes but in
some cases other organs nearby, like the bowel and bladder, can be affected during the menstrual cycle.
This misplaced endometrial tissue also responds to the hormones of the menstrual cycle and grows
while not connected to the uterus. This tissue becomes inflamed and causes irritation and
scarring of the normal tissue around those organs.
What are symptoms of endometriosis?
The most common symptom of endometriosis is repeating pain where someone has pain during
the period of bleeding every month, and often starting a few days before the bleeding,
and then improving after the bleeding ends.
Other common symptoms are chronic pelvic pain, irregular or heavy periods and often pain during intercourse.
Endometriosis may also affect the intestines and cause symptoms like nausea, vomiting or bloating,
and even constipation or diarrhea. These symptoms can all be worse during your period.
However, some people with endometriosis have no symptoms at all. Some women with endometriosis may
be more likely to have infertility or difficulty getting pregnant.
What causes endometriosis?
Endometriosis is complex, it can be caused by a combination of genetic and environmental factors
but the exact cause is really not known. One theory is that the menstrual blood flows up instead
of out and deposits into the abdomen around the uterus in a sort of reverse menstruation.
Another idea is that the endometrial cells from the uterus travel through the blood and
lymphatic channels and implant in a different location. Other theories suggest that any cell
may transform into an endometrial cell and cause these misplaced cells to grow.
Someone may be more likely to have endometriosis if they have a close family member like a parent
sibling or child that has endometriosis. Or if they had their first period at an
early age, if they've never had children or if they have an abnormal uterus. Unfortunately we
don't know any ways to prevent endometriosis.
How is someone diagnosed with endometriosis?
Diagnosis begins with evaluation by a health care provider and the diagnosis is often based
on your history, the symptoms that you're having, and a physical exam, including a pelvic exam.
Although the official diagnosis is not certain without looking with a laparoscope or a small
camera that goes into the belly button. Surgery is not always needed. Your provider will offer
treatment based on your symptoms and discuss if and when surgery may be right for you.
How is endometriosis treated?
Treatment options should be discussed with your health care provider.
They will consider your symptoms your health and medical history, extent of your symptoms, and your preference or desire for future pregnancy.
In general anti-inflammatory medications like ibuprofen and naproxen or hormone therapy like birth control pills or even a hormonal iud
can provide relief from symptoms and prevent it from getting worse over time.
More serious cases can be treated with surgery to remove the endometriosis and in some severe cases
even a hysterectomy or removal of the uterus and possibly the ovaries are used.
How is endometriosis managed?
Endometriosis can be mild or severe and is a lifelong disease that can get worse over time
and has a high chance of returning even after treatment. That can feel frustrating to those
that are affected. Emotional support to help with coping is an important part of keeping
someone with endometriosis well. In addition to relieving symptoms with hormone therapy
or anti-inflammatories, other comfort measures can also be helpful. Regular exercise, emotional support
through counseling, good nutrition and other complementary therapies are also beneficial.
Please speak to your health care provider if you think you may have endometriosis
and together you can decide the treatment that is best for you. I have many patients
with endometriosis who find ways to manage it and go on to live their lives normally.