What is Endometriosis?
If you have endometriosis, you know it causes pain and cramping, which can sometimes be severe, especially during your period. It can even create problems when you want to have a baby. But what exactly is endometriosis and what causes all the symptoms that are associated with it?
Endometriosis occurs when tissue that should line the inside of your uterus, the endometrium, grows outside of it instead. Even though the tissue is outside of your uterus, it still acts like it should during your menstrual cycles. That means at the end of your period, this tissue will break apart and bleed.
However, the blood from this tissue has no place to go. Surrounding areas may become inflamed or swollen, and scar tissue and lesions can develop. The most common site for endometriosis is on your ovaries.
Many times, endometriosis has no symptoms. When symptoms are present, they may include:
- Abdominal cramps or back pain during menstruation
- Severe menstrual cramps
- Painful bowel movements or urination, especially during menstruation
- Abnormal or heavy bleeding during periods
- Painful sex
- Difficulty becoming pregnant
Doctors don’t know exactly what causes endometriosis. Some experts think that menstrual blood with endometrial cells travels back through the fallopian tubes and passes out into the pelvic cavity where the cells stick to the organs. This is known as retrograde menstruation.
Genetics may also play a role in whether you get endometriosis. If your mom or sister have it, you’re more likely to get it, also. And research shows that when there is a hereditary link, the disease seems to be worse in the next generation.
Some women with endometriosis also have immune system disorders. But doctors aren’t sure whether this is a cause or an effect of the endometriosis.
If you have any symptoms of endometriosis or are having difficulty becoming pregnant, contact your gynecologist. There are several things she can do to determine if you have endometriosis, including:
- Pelvic exam and history
- Ultrasound exam
There is no known cure for endometriosis. Treatments usually include surgery or medication to manage symptoms.
- Pain medication. If your symptoms are manageable with over-the-counter medications, your doctor will likely suggest you take a pain reliever such as an NSAID like ibuprofen (Advil, Motrin) or naproxen (Aleve). If these don’t relieve your pain, talk to your doctor about other options.
- Hormones. Hormonal therapy is used to minimize the amount of estrogen your body creates, and to prevent your menstrual period. This helps lesions bleed less, which decreases inflammation, scarring, and cyst formation. Common hormones prescribed include:
- 1. Birth control pills, patches, and vaginal rings
- 2. Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists (elagolix sodium/Orilissa, leuprolide/Lupron and Synarel)
- 3. Progestin-only contraceptives. Talk to your doctor about which options are best for you.
- 4. Danazol (Danocrine)
- Surgery. For some cases, surgery to remove as much of your endometriosis as possible may be necessary. In some cases, surgery improves symptoms and may increase your chances of pregnancy. Sometimes pain returns, though. Your doctor can perform surgery laparoscopically, which is less invasive, or through standard abdominal procedures, so be sure to discuss all of your options.
In the most severe cases of endometriosis, a hysterectomy to remove the ovaries, uterus, and cervix may be the best option available. This is usually considered the last option, especially if you still want to have children.
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