What is endometriosis?

The endometrium is the lining of the uterus. During menstruation, this lining is shed both through the cervix (seen as menstrual blood) and back through the fallopian tubes where the uterine lining cells and blood drip into the pelvis. Endometriosis occurs when some of these cells continue to grow outside of the uterus. The cells can attach to the fallopian tubes, intestines, ligaments supporting the uterus, and the ovaries. Sometimes large cysts are formed. Endometriosis is a chronic, progressive condition.

Endometriosis Association

Why is endometriosis a problem?

The changes in your monthly hormone cycle stimulate the endometrial tissue to grow and bleed. Because the tissue has no way of getting out of the abdomen it can cause pain before and during menstruation. The ongoing monthly process of growth, bleeding, and healing can cause scar tissue in the pelvis and this scarring can cause infertility.

Signs and Symptoms

Pain:

• Pain before and during menstrual periods (usually worse than normal menstrual cramps)
• Pain during or after sexual intercourse
• Pain in the lower back and/or pain with bowel movements during menstrual periods
• Pain in the pelvic area

The signs and symptoms can be very different from woman to woman, making it difficult to diagnose. Pain is not always present.

Other symptoms include:

• Abnormally heavy or long menstrual periods
• Infertility
• Blood in your bowel movements during your menstrual period

How is it diagnosed?

If your mother or sister has similar symptoms and have been diagnosed with endometriosis, you might suspect that you have the disease, as well. However, an accurate diagnosis can only be made by performing surgery, usually a laparoscopy. Laparoscopy is an outpatient surgical procedure in which a slim telescope is inserted through a very small opening made in the navel. This allows your doctor to examine the abdominal organs and evaluate the extent of the disease.

How is this treated?

Treatment can include surgery or medication. Your doctor can remove areas of endometriosis through the laparoscope to reduce pain and to increase your chances of pregnancy.

Medical therapy consists of:

• Analgesics (pain killers)
• Oral contraceptives (birth control pills), which help by temporarily stopping the release of stimulatory hormones
• Special hormone drugs used to temporarily shrink endometrial deposits

Conclusion

Although endometriosis surgery is often very helpful relieving pelvic pain, it is less successful in helping a woman become pregnant. Endometriosis almost always grows back; more quickly if only medication is used, and more slowly if you have surgery. It is important to know that while you are taking medications to help endometriosis, you will not be able to get pregnant. In many cases of infertility due to endometriosis, in vitro fertilization (IVF) has proven to be a very successful therapy.