What is Endometriosis?
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus, commonly on the ovaries, fallopian tubes, and the tissue lining the pelvis. This tissue responds to the hormonal changes of the menstrual cycle, thickening, breaking down, and bleeding. However, because this tissue is outside the uterus, it has no way to exit the body, leading to inflammation, pain, and the formation of scar tissue.
Symptoms
The symptoms of endometriosis can vary widely among individuals, and some women may experience severe symptoms, while others may have mild discomfort or none at all. Common symptoms include:
Pelvic Pain: This is the most common symptom, ranging from mild to severe, and often intensifies during menstruation.
Painful Periods (Dysmenorrhea): Women with endometriosis often experience unusually painful periods, which may include lower back pain and abdominal cramping.
Pain During Intercourse (Dyspareunia): Endometriosis can cause pain during or after sexual intercourse.
Heavy Menstrual Bleeding: Some women with endometriosis experience heavier than normal menstrual bleeding or bleeding between periods.
Infertility: Endometriosis can also lead to difficulty conceiving, although not all women with the condition are infertile.
Diagnosis
Diagnosing endometriosis can be challenging, as its symptoms can mimic those of other conditions such as pelvic inflammatory disease or irritable bowel syndrome. It is unfortunately common for women with endometriosis to not receive a diagnosis for several years as they navigate their care. This is because of many reasons, one being endometriosis is not often visualized on imaging which is frustrating for most patients. To prevent delay in treatment, recommendations for diagnosing endometriosis based on a medical history and clinical symptoms is now the focus, as it allows for early treatment and improving quality of life. Ultimately, the only way to definitively diagnose endometriosis is through laparoscopy—a surgical procedure where a camera is inserted through a small incision in the abdomen to view the pelvic organs directly to obtain biopsies of tissue visualized.
Treatment Options
While there is currently no cure for endometriosis, several treatment options can help manage symptoms and improve quality of life and depending on your goals:
Non-Medication Treatments: using a heating pad, TENS unit, pelvic floor physical therapy, vitamins/supplements (vitamin C, fish oil/Omega-3, magnesium glycinate), and an anti-inflammatory diet.
Pain Medication: Over-the-counter pain relievers such as ibuprofen or NSAID’s can help alleviate pelvic pain and menstrual cramping.
Hormonal Therapy: Birth control pills, patches, vaginal rings, implant or IUD can help regulate hormonal fluctuations and reduce the growth of endometrial tissue and prevent pelvic pain symptoms. Discuss which option might be right for you with your midwife or provider.
Gonadotropin-releasing Hormone (GnRH) Agonists and Antagonists: These medications work by blocking the production of certain hormones, temporarily inducing a menopausal state to relieve symptoms (i.e. Orilissa).
Surgery: In cases where medication fails to provide relief, surgery may be recommended to remove endometrial implants and scar tissue. This can often be done laparoscopically, with smaller incisions and shorter recovery times compared to traditional open surgery.
Fertility Treatment: For women struggling with infertility due to endometriosis, fertility treatments such as in vitro fertilization (IVF) may be an option.
Endometriosis is a chronic and often debilitating condition that can significantly impact a woman's quality of life. By raising awareness we can better women affected by this condition. If you or someone you know is experiencing symptoms of endometriosis, schedule an appointment here to discuss options for your care.
