Endometriosis

Endometriosis (pronounced end-oh-mee- tree-oh-sis) is one of the most common diseases affecting women in their reproductive years. This disease will start quietly. The endometrial implants or growths will develop unnoticed inside the pelvic cavity. This will go on until the pain or heavy periods interfere with the woman’s life and she seeks medical advice. It is a painful disease of the female reproductive system. Endometriosis is not an infection, it is not contagious, and it is not cancer.

It is estimated that 10-15 percent of American women capable of childbearing have endometriosis. The pain of endometriosis can range from mild to severe. At times, a woman’s daily activities can be interrupted due to severe pelvic pain. Some women have less endometrial pain after pregnancy. Endometriosis is treated when the symptoms disrupt a woman’s daily activities or if she has infertility problems.

There are also women that do not have severe pain with endometriosis, and some women have no symptoms at all. Others do not find out they have endometriosis until they have trouble becoming pregnant. Endometriosis is one of the top three causes of infertility. Endometriosis can cause scars and adhesions on ovaries or fallopian tubes and prevent pregnancy.

With endometriosis, tissue that normally lines the uterus is found growing outside of the uterus. The tissue can be found growing on fallopian tubes, ovaries, bowel, and bladder. In rare cases, endometrial tissue can grow in other parts of the body also.

Endometrial tissue responds to the menstrual cycle. It thickens, breaks down, and sheds itself every month. This is seen as blood during a woman’s period, and it leaves the body through the vagina. In endometriosis, the blood and endometrial growths have no way to leave the body, thus causing inflammation and pain.

Although some women will have no symptoms of endometriosis, most women will have one or more of the following symptoms:

  • Pelvic pain
  • Lower back pain
  • Painful intercourse
  • Heavy painful periods
  • Painful bowel movements
  • Painful urination
  • Diarrhea
  • Constipation
  • Nausea
  • Infertility

The amount of pelvic pain a woman has does not necessarily correlate with the extent of endometriosis she has. Some women with extensive disease have little or no pelvic pain. In other words, the degree of pain it causes is not related to the extent of the disease. Endometriosis is not the only disease that can cause pelvic pain.

Experts do not know the cause of endometriosis. Several theories are being researched. The researched topics include genetics, retrograde menstrual flow or menstrual back flow, hormone related causes, immune system related causes, and environmental reasons.

After a woman receives a thorough history and physical, imaging tests might be ordered. Imaging tests are ultrasounds, CT scans, or MRIs. These imaging tests would give a picture of the inside of the body. Through these tests, large areas of endometriosis might be identified and it may be useful to get more information about the extent of the disease.

Endometriosis cannot be diagnosed from symptoms alone. The only true way endometriosis can be diagnosed is through a surgical procedure called a laparoscopy. A laparoscopy is performed in surgery under anesthesia. This can be done on an outpatient basis.

During a laparoscopy, the surgeon makes small cuts in the abdomen, inflates the abdomen with gas, and inserts an instrument called a laparoscope into the abdomen. Through the laparoscope, the pelvic and abdominal organs can be seen. A biopsy of the endometrial tissue can be taken and sent to the laboratory for examination. By examining this tissue, a diagnosis of endometriosis can be made.

Unfortunately there is no cure for endometriosis. The goal of treatment would be to relieve or reduce pelvic pain, slow endometrial growths, or increase fertility.

Pain Relief Medication

Some pain relief treatments include:

  • Use of over the counter medication such as NSAIDS (ibuprofen or naproxen sodium)
  • Prescription medication

 

Hormone Therapy

  • Birth control pills help to regulate the tissue growth
  • Progesterone reduces the woman’s period
  • Danocrine interferes with ovulation, preventing production of hormones that trigger endometrial growth
  • Gonadatropin brings on “medical menopause,” ending the production of estrogen and progesterone, the hormones that fuel endometriosis

 

Surgery

  • Laparoscopy is used to diagnose endometriosis
  • Hysterectomy is the surgical removal of the uterus
  • Salpingo-oophorectomy is the surgical removal of a fallopian tube and ovary
  • LUNA … Laparoscopic Uterine Nerve Ablation cuts the nerves in the pelvis to lessen the pain, used in extreme cases of pain

 

Infertility

  • In vitro fertilization involves taking eggs from the woman, fertilizing them in the laboratory with her partner’s sperm and transferring the resulting embryos back to her uterus.
  • Laparoscopy can remove endometrial tissue
  • Ovulation induction involves using medication to increase fertility

 

A woman does not have to live with the symptoms of endometriosis. Much can be done to help alleviate the pain and discomfort associated with the disease. Discuss your concerns with your physician and plan to live a healthy life.

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