Endometriosis

What is endometriosis?

Endometriosis is a medical condition in which the lining of the uterus grows on the outside of the uterus.

Symptoms of endometriosis

Endometriosis symptoms are similar to those of other health problems. Contact your doctor if you have:

  • Heavy menstrual bleeding.
  • Severe cramping or pain before and/or during your period.
  • Frequent spotting or bleeding between periods.
  • Pain while going to the bathroom during your period.
  • Pain with sex
  • Pain in your stomach, low back, or rectum.
  • Problems with fertility.
  • Unexplained exhaustion or lack of energy
  • Digestive or gastrointestinal issues or symptoms.

The location and size of patches do not relate to the amount of pain you may have.

What causes endometriosis?

Doctors and researchers do not know the cause of endometriosis. Genetics plays a part. It can run in your family. Retrograde (backwards) menstrual flow is another possible cause. This is when some of the tissue that is shed during your period flows up instead of out. It ends up in your fallopian tubes and other parts of your pelvis.

Other factors include your body’s response to estrogen and progesterone. If your body resists progesterone, it can have a hard time shedding the uterine lining. Some people have flawed immune systems. This means their bodies don’t destroy all of the lining. The leftover lining then attaches to the outside of your uterus.

How is endometriosis diagnosed?

Your doctor will do a physical and pelvic exam. He or she also will review your symptoms, health history, and family history.

Laparoscopic surgery confirms the diagnosis. This common procedure allows the doctor to look inside your uterus. Your doctor will make a small cut in your abdomen. He or she will use a small, lighted camera to look for patches of endometriosis. Your doctor may take a sample of tissue to the lab.

Can endometriosis be prevented or avoided?

You cannot prevent or avoid endometriosis. Some women have an increased risk for the condition. Factors that increase your risk include:

  • Family history.
  • Starting menstruation early (before the age of 11).
  • Short menstrual cycles (27 days or less).
  • Long, heavy periods (7 days or more).
  • Starting menstruation late.
  • Low body fat.
  • Regular exercise (4 or more hours each week).
  • Pregnancy.

Endometriosis treatment

Several types of medicine can treat endometriosis, including:

  • Over-the-counter medicine can relieve pain and inflammatory.
  • Birth control pills can regulate your hormones and reduce heavy bleeding.
  • The hormone, progestin, can manage symptoms over time. It comes in the form of a shot or a pill.
  • Danazol and GnRH analog are hormone shots that stop your periods. This gives your uterus a break from a buildup of tissue. Unfortunately, these shots have side effects similar to menopause. These include hot flashes, vaginal dryness, and unwanted facial hair. Taking a daily estrogen pill can reduce these side effects.
  • Aromatase inhibitors, such as exemestane and letrozole, are a newer type of hormonal treatment.

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

Your doctor may recommend a procedure. It could be surgery or a diagnostic laparoscopy. In this procedure, the doctor removes the endometrial tissue that has grown outside of your uterus. As a last resort, your doctor may recommend a hysterectomy. This is would be the surgical removal of  your uterus, and sometimes ovaries.

Living with endometriosis

Endometriosis can make it harder to get pregnant. You may need surgery and/or fertility treatments to help. Talk to your doctor if you plan to become pregnant. Your doctor may advise you to not put it off. The condition can get worse with age, so your chances of getting pregnant lessen over time. Usually, symptoms go away while you’re pregnant. Do not take prescription medicine when you’re trying to get pregnant.

Some studies have suggested that endometriosis may put you at a higher risk of getting ovarian cancer. However, the overall risk is low. Endometriosis often goes away or becomes milder with menopause. Until menopause, medicine and/or surgery may be able to help with symptoms.

Questions to ask your doctor

  • What are the benefits and risks of surgery?
  • What can I do to improve my chances of getting pregnant?
  • What is the recovery time for a laparoscopic procedure?