Learn the Facts on Endometriosis
Endometriosis is one of the most common gynecological ailments, affecting more than 5 million women of childbearing age in the United States. It occurs when endometrium—the type of tissue that lines your uterus—grows outside your uterus, forming clumps called “implants.” These implants may develop on the ovaries, fallopian tubes, outer wall of the uterus, or on organs in the pelvis or abdomen.
When endometrial tissue is located outside your uterus, it acts as it normally would during a menstrual cycle: it thickens, breaks down and bleeds. Blood from implants cannot exit the body and becomes trapped, causing irritation and the development of cysts, scar tissue and adhesions—abnormal tissue that binds organs together. Endometriosis also causes fertility problems for an estimated 30-40% of women with the disease.
The cause of endometriosis remains uncertain; however, researchers are studying the roles that hormones, the immune system and genetics play in this disease.
Symptoms
According to Dr. Dan Kegel, a physician at OB-GYN of Lancaster, endometriosis typically presents in one of three ways:
- The patient is having difficulty conceiving, requiring an infertility workup that includes laparoscopy
- She is experiencing pelvic pain, usually timed to her menstrual cycle
- The patient has a pelvic mass or ovarian cyst requiring further examination through surgery or ultrasound
Other symptoms include heavy or long periods, fatigue and gastrointestinal problems, especially during menstruation.
Dr. William Bradford of May-Grant Associates adds, “Endometriosis sometimes mimics irritable bowel syndrome (IBS) so you want to be sure to look at all possible causes of these symptoms.”
Diagnosis
Endometriosis can be frustrating to diagnose. Dr. Bradford explains, “The amount of pain a woman feels is not a reliable indicator of how much endometriosis she has. A woman may have adhesions that cause ‘frozen pelvis’ but she may show very little symptoms. On the other hand, a woman may have a lot of pain with only minimal disease, making it more difficult to spot the implants during surgery. This explains why many doctors recommend trying pain medication before surgery.”
The most accurate way to diagnose endometriosis is with a type of minor surgery called laparoscopy, which enables physicians to spot implants, scar tissue or cysts. These can be removed during the same surgery.
Treatments
While there is currently no cure for endometriosis, there are effective treatments including:
- Pain medication
- Hormone therapy to control the growth of endometriosis
- Conservative surgery to remove growths, scar tissue and adhesions and to relieve pain
- Hysterectomy and removal of both ovaries—in severe cases only
“Endometriosis is not life threatening,” Dr. Kegel explains. “It does affect quality of life, however, and the treatments we recommend must be tailored to the individual patient. For example, surgically removing an affected ovary may be beneficial to an older patient, but may be inappropriate for someone younger.”
Left undiagnosed or untreated, endometriosis can be a frustrating and painful condition that can worsen over time, so it is important to seek treatment if you suspect you have it. You may also want to consider joining a support group to cope with the related emotional distress.
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