Women’s Health Spotlight: What is Endometriosis?

What is Endometriosis?

If you’ve been experiencing excessive or abnormal menstrual pain, it’s worth talking to your healthcare provider about endometriosis. An estimated 2% to 10% of American women ages 25 to 40 suffer from endometriosis, and those who do are more likely to experience infertility or difficulty getting pregnant. 

Endometriosis occurs when the tissue that lines the inside of the uterus – the endometrium – grows on the outside of the uterus. This tissue behaves just like it would inside the uterus, building up, then breaking down and bleeding. However, in the case of endometriosis, there is nowhere for the tissue to go, which can then irritate surrounding tissue leading to eventual scar tissue or adhesions. 

It’s important to understand the signs, symptoms and solutions of endometriosis to help avoid extreme pelvic pain, difficulty getting pregnant or infertility. 

Understanding Endometriosis

Common symptoms of endometriosis include:

• Painful menstrual cramps that can radiate beyond the pelvic area into the low abdomen or lower back
• Pain during or after sex
• Pain with urination or bowel movements during a menstrual period
• Fatigue or low energy levels
• Diarrhea or constipation during menstrual period
• Spotting or bleed between periods
• Excessively heavy menstrual periods
• Infertility

There are some things that can mean a woman has a higher risk of developing endometriosis, including:

• An abnormal uterus
• Early menstruation (before 11 years old)
• Shorter menstrual cycles (less than 27 days on average)
• A mother, sister or daughter who has endometriosis
• Heavy menstrual periods that last more than seven days

Conversely, some things that lower the risks are:

• Pregnancy and breastfeeding
• Starting your period after 14 years old

Diagnosing Endometriosis

There are a variety of ways your primary care provider, obstetrician or gynecologist can diagnose endometriosis. Your medical and family history and any associated symptoms will dictate the type of testing used. 

Non-surgical methods include diagnostic imaging such as an ultrasound or an MRI. The ultrasound uses sound waves to view organs while an MRI is a non-invasive imaging method that uses magnetic waves to view organs and tissues inside the body, noting any abnormalities. 

For actual examination of the uterus and surrounding tissues, your physician might recommend laparoscopy, a procedure in which a small tube with a light and camera is inserted through a small incision in the skin to view the tissue. If there is suspicious tissue, the doctor can take a small sample of cells, known as a biopsy, to test for a definitive diagnosis. 

Treatment Options

Endometriosis treatments vary from over-the-counter, non-surgical options to surgery, including:

• Hormone therapy – treatments that use hormones to alter hormone levels, helping to prevent the hormone swings that happen during a menstrual cycle that can make endometriosis worse. 
• Pain medications such as ibuprofen can be effective in managing endometriosis pain.
• Laparoscopy – the same process used to diagnose endometriosis can be used to treat more severe cases.
• Laparotomy 
• Hysterectomy – a surgical procedure in which the uterus is removed entirely.
• Complementary and alternative approaches such as acupuncture 

Finding ways to manage daily stress is another important tool. Common calming techniques and practices include yoga, exercise, going for a walk, listening to calming music, meditation and aromatherapy. Also, make sure to get plenty of sleep and practice good sleep hygiene. 

If your endometriosis becomes overwhelming, talking with a therapist or a support group can be helpful. Talk with your primary health care provider or mental health professional about options near you. 

Endometriosis and Fertility

According to the American Society for Reproductive Medicine, 24% to 50% of women with infertility have endometriosis. While doctors don’t know exactly how endometriosis affects infertility, there is a direct correlation between the two. However, it’s important to note that many women with endometriosis can still get pregnant and enjoy a full-term and successful pregnancy. Talk with your doctor about your fertility and family planning goals when discussing endometriosis. 

For those suffering from endometriosis who want to get pregnant, there are treatment options, including surgery to remove the endometrial tissue and fertility preservation such as in vitro fertilization (IVF). 

Conclusion

Endometriosis can be painful and scary, but those who suffer from it are not alone, and there are a variety of treatment options available. Reproductive health is an important part of women’s overall wellness. Talk with your doctor if you’re worried you might have endometriosis.