Endometriosis is chronic condition in which the cells from the uterine lining, called the endometrium, grow in places outside of the uterus. The most common areas affected by endometriosis are the ovaries, fallopian tubes, intestines and walls of the pelvis. While endometriosis usually isn’t dangerous, it can cause painful periods and infertility. Since the symptoms of endometriosis can be vague, the average time to diagnosis is more than 7 years.
During a normal menstrual cycle, the endometrium thickens with blood. If a pregnancy does not occur, the endometrium is then shed as your menstrual cycle. For women with endometriosis, the same changes occur. The endometrial implants thicken and then bleed. This bleeding can cause severe pain during the menstrual cycle, especially in the lower abdomen, back, and rectum. When endometriosis is advanced, women may have pain throughout the cycle and during sex. In addition, the bleeding may cause inflammation and scar tissue in the pelvis, causing infertility. Endometriosis usually does not cause the periods to be irregular or heavy in flow.
An accurate diagnosis of endometriosis can only be made by visualizing the endometrial implants in surgery. There are no other tests that can be done to confirm its presence. It cannot be seen on an Xray, ultrasound, CT, or MRI. For this reason, women may be treated for endometriosis based on their symptoms alone. If a woman has debilitating pelvic pain at the time of menses, a doctor may presume that she has endometriosis and treat her accordingly.
While there is no cure, the treatment of endometriosis involves medications, and in more severe cases, surgery. Hormonal Birth control methods, like the pill, shot, or ring, will shut down your ovulation and periods will be lighter. Periods will be lighter. As a result, the bleeding from endometrial implants lessens as well. Anit-inflammatory drugs, like ibuprofen, will decrease the inflammation from the implants and the pain. Alternative therapies have been suggested such as herbal medications (blue cohosh, cranberry, St. John’s wort) and accupuncture.
If the medical treatments aren’t effective, surgery is another treatment option. The endometrial implants and scar tissue can be removed laparoscopically. In the most severe cases, a hysterectomy with removal of the ovaries may be necessary.
Endometriosis affects 6-10% of women during their reproductive years. Having a baby can greatly alleviate symptoms, as does going through the menopause. If you have painful periods or infertility, you should talk to your doctor about the possibility of this diagnosis.