Endometriosis

The word "endometriosis" (say: "end-oh-me-tree-oh-sis") means a problem with the lining of the uterus. The lining is called the endometrium. Normally, every month when you have your period, the lining (which is also called endometrial tissue) comes out in your menstrual flow.

Endometrial tissue is usually only inside your uterus. However, if you have endometriosis, tissue from the lining of the uterus moves through the fallopian tubes and gets on your ovaries, in your pelvis, on your bladder or in other areas. When you have your period, this tissue swells and bleeds, just like the lining of your uterus. This is often painful, and scar tissue can form in your pelvic area.

Endometriosis may hurt, but it doesn't cause cancer or affect your overall health, although it might make it harder to get pregnant.

There's no easy way to tell you have this problem. If you have severe cramping and pain during sex or at the beginning of your period, or low back pain or rectal pain, you may have endometriosis. If you have these kinds of pain, your doctor still may not be sure if endometriosis is the cause. Many other health problems can cause pain like this. The only way for your doctor to be sure is to do a laparoscopy (say: "lap-ah-ross-ca-pee"). This is a way of looking inside your uterus by making a small cut in your skin and putting a thin tube inside. If your doctor decides to perform this procedure, you will be given medicine so you won't feel any pain.

A number of medicines might help with your pain. Sometimes it helps to take birth control pills. Another medicine that might help is a long-acting progestin (this is a hormone that comes in a shot; it's also used for birth control). Other medicines are danazol (brand name: Danocrine) or a monthly shot of a hormone called a GnRH analog.

These medicines stop your periods. They may cause side effects like the ones women have at menopause. These include hot flashes and vaginal dryness. Danazol might cause acne and unwanted facial hair. Sometimes the side effects of the GnRH analog go away if you also take an estrogen pill every day.

Birth control pills, danazol and GnRH analogs are taken for 6 to 9 months. During that time, your pain should get better. After you stop taking the medicine, the pain may come back.

It's important not to get pregnant while you're taking these medicines. And if you want to get pregnant after the treatment is over, these medicines don't improve your chances of getting pregnant. If you don't want to get pregnant after the treatment, you should keep using birth control.

Surgery is also used to treat endometriosis. In this surgery, the doctor removes the endometrial tissue from the wrong places. If endometriosis is keeping you from getting pregnant, surgery might make it easier for you to get pregnant. However, you might still need other kinds of fertility treatments if you want to get pregnant.

For many women, endometriosis goes away at menopause, when periods stop. Until menopause, medicine and surgery may be able to help with symptoms of endometriosis.