Endometriosis

Endometriosis is a common condition that occurs when the tissue lining the inside of the uterus spreads to the outside, often attaching to the ovaries, fallopian tubes, the uterus' outer surface, the pelvic cavity's lining, or other parts of the lower abdomen. Endometriosis occurs only in menstruating women, and its cause is unclear.

The small pieces of misplaced tissue are sometimes called endometrial lesions or implants and still respond to monthly menstruation – it builds up, breaks down, and bleeds. But whereas tissue and fluids within the uterus are expelled during menstruation, the tissue from endometriosis has no place to go. As a result, the tissue can inflame and form scar tissue.

Endometriosis Symptoms

The symptoms of endometriosis may include pain, infertility, and abnormal menstrual bleeding. Related pain can be severe and might occur at different points in the menstrual cycle. Yet some women with even severe endometriosis may not experience discomfort.

Regardless of the severity of pain, getting an accurate diagnosis is important. Even mild cases can affect fertility due to organ damage, embryo implantation problems, increased white blood cells within the abdominal area, and stress on the immune system.

The only way to definitively diagnose the disease is with direct inspection via laparoscopy, although pelvic or ultrasound exams may suggest endometriosis. In laparoscopy, a physician inserts a long, thin, lighted, telescope-like instrument through a small surgical incision just below the navel. The physician can then view and treat any endometriosis or other pelvic conditions requiring attention.

Treatment of endometriosis

Doctors usually treat endometriosis with hormone therapy, surgery, or both.  For mild or moderate endometriosis pain, nonprescription pain relievers (aspirin, acetaminophen, or ibuprofen) may be helpful. For more severe or unresponsive pain, some women may need a prescription pain medication.

Hormone therapy includes the use of oral contraceptives (estrogen, progestins, or both), danazol, or GnRH agonists. These medications work by stopping ovulation temporarily. Inhibiting ovulation can help shrink the endometrial lesions and stop the development of new implants. Unfortunately, hormone therapy does not cure endometriosis, which usually recurs when hormone therapy stops.

Physicians also can remove endometrial implants and scar tissue by cutting away, cauterizing (burning), or vaporizing them with a laser, usually done during a laparoscopic inspection. If endometriosis is severe or if the implants cannot be reached easily with the laparoscope, a more extensive kind of surgery – laparotomy – may be beneficial, requiring a larger incision of about four to five inches.

For many women, hormone therapy and/or surgery to remove endometrial implants helps to relieve symptoms temporarily and can make conception possible. Some severe cases may be reason for sufferers to consider hysterectomy and removal of the ovaries.

Helping to prevent endometriosis

Research is ongoing to determine the causes of endometriosis. For now, many believe that three possible sources increase the odds of endometriosis: genetics, immunological disorders, and exposure to the environmental contaminants dioxin or organochlorine. In addition to regular medical care, you can take two steps for self care: stay informed, and, if the disease is causing ongoing problems and struggle, seek the support of other women who are going through the same experiences.

The Endometriosis Association, a non-profit, self-help organization for women with endometriosis, provides information and promotes research about the condition. Chapters located throughout the United States and Canada are local resources for information and support.