Endometriosis is a condition in women where cells of the endometrium, the tissue that lines the inside of the uterus and is shed during menstruation every month, are found outside of the uterus. In most cases the cells are found on organs in the abdomen like the ovaries, Fallopian tubes, or bladder; but in rare cases it can be found in other parts of the body like the lungs and the diaphragm.
These cells react to estrogen hormones by multiplying and swelling, but unlike endometrial cells in the uterus, endometrial cells in other parts of your body can not escape during menstruation. Instead they build up and create patches on normal tissue, and can cause irritation and adhesions (sticky attachments) between the organs.
The exact number of women suffering from endometriosis is unknown because so many women are either asymptomatic, or assume that their issues are normal menstrual symptoms. However, according to researchers, an estimated 176 million women live with the disease worldwide. The pain from endometriosis can be debilitating and cause women to miss school, work, decrease quality of life, and lead to other health issues. Awareness initiatives have done a great deal to help women and their doctors understand the realities of the disease and improve responses to women’s pain issues. Doctors are realizing that endometriosis is not “just cramps”, and women can now get the help they need.
Women generally begin to experience the effects of the disease between the ages of 25-40, but it can start as soon as a woman begins menstruation. The most common symptoms are:
- Extremely painful or heavy periods
- Painful sex
- Pain in lower abdomen or pelvic area (sometimes constant, but worse closer to the period)
- Bleeding between periods
- Painful urination or bowel movements during your period
- Difficulty getting pregnant(infertility)
Many women only discover the condition once they have difficulty becoming pregnant—approximately 2/3 of endometriosis suffers experience difficulty conceiving. In order to diagnose endometriosis your doctor will most likely order a laparoscopy, a minimally invasive procedure where the surgeon, using anesthesia, inserts a small camera through an incision in the abdomen and searches for signs of endometriosis inside the body. This type of surgery is relatively simple and has a very quick recovery time.
The exact cause of endometriosis is unknown, though there are numerous theories, including genetic and environmental influences or immune system complications. Research is underway to understand the source of the disease and therefore one day hopefully develop a cure. Scientists have, however, found some factors that can increase your risk for the condition. If your mother or sister has endometriosis, you might be at a higher risk as the condition sometimes runs in families. Women who start their period earlier or who have not had children are also more likely to experience problems with endometriosis.
Treatment options for endometriosis depend upon many factors:
- Your age
- Severity of symptoms
- Spread of the disease
- Whether you want children in the future
If you have a mild case of endometriosis your doctor might recommend managing the condition with more conservative treatments. This could include regular exercise, over the counter painkillers like ibuprofen and acetaminophen, or even prescription painkillers. Your doctor will also monitor your symptoms with regular exams to ensure that the condition isn’t spreading or getting worse.
If your condition is more advanced your doctor might suggest hormone therapy to manage your symptoms. Since endometriosis is reactive to your body’s natural estrogen hormones, it gets worse during menstruation so hormone medications can help you stop or even reverse some of the growths and alleviate some of the pain. Hormone treatments can range from something as simple as the birth control pill or injection to more complicated hormone therapies that are unrelated to contraception. Your doctor will be able to explain all of the hormone options and help you choose the one that is right for you.
If your case is severe or you are concerned about fertility, your doctor might recommend surgery to resolve some of the issues related to endometriosis. Surgery can be done a number of ways, but as technology improves doctors are opting for less invasive options, like laparoscopy, over more invasive methods. During laparoscopic surgery the doctor will again thread a small camera through an incision in the abdomen in order to find and remove patches of endometriosis. More invasive surgeries involve a large incision to remove more extensive patches of the disease and any cysts that might have formed. In extreme cases or if the woman does not want children in the future, the doctor will recommend the complete removal of some of your reproductive organs such as your uterus (hysterectomy) and/or your ovaries (oophorectomy) which results in immediate menopause.
As awareness about endometriosis has increased, there has been a surge in the amount of research into the disease. Women are no longer keeping quiet about their pain and the full impact of the disease on women’s lives is being realized. Conservative treatments for the condition are often successful and help women manage their symptoms effectively without having to resort to invasive surgery. If you are experiencing the symptoms of endometriosis, don’t hesitate to see your doctor—there are treatments and support groups that can greatly improve your quality of life.