What is endometriosis?
Endometriosis is a condition in which the cells that normally are found in the uterus grow in other areas of the pelvis. The tissue that lines the uterus is called the endometrium. Each month, the endometrium thickens, and then bleeds as a period. When a woman has endometriosis, the misplaced tissue similarly responds to the hormonal changes of the menstrual cycle. It builds up, breaks down and bleeds. This causes surrounding tissue to become inflamed or swollen, leading to scar tissue and chronic pain.
Endometriosis can make it more difficult to become pregnant, though the majority of woman with endometriosis are able to conceive normally
What causes endometriosis?
According to Allison Hill MD, an OB/Gyn at PIH Health Women’s Center-Wilshire, “The cause of endometriosis is not clear. One theory is that during a woman’s period, some of the blood containing endometrial cells flows the wrong direction into the abdomen. Other theories suggest genetic or immune system abnormalities.”
Who is at risk for endometriosis?
Any woman may develop endometriosis, but the following women seem to be at an increased risk for the disease:
- Women who have a mother, sister, or daughter with the disease
- Women who gave birth for the first time after age 30
- White women
- Women with an abnormal uterus
What are the symptoms of endometriosis?
Each woman may experience symptoms differently, but these are the most common symptoms:
- Pain and cramps that may be felt in the belly or lower back during your period
- Pain during sex
- Painful urination during your periods
- Painful bowel movements during your periods
- Other digestive problems, such as diarrhea, constipation, or nausea
The amount of pain a woman has isn’t always related to the severity of the disease. Some women with severe disease may have no pain. Other women with a milder form of the disease may have severe pain or other symptoms.
How is endometriosis diagnosed?
Unfortunately, there is no easy way to make the diagnosis of endometriosis. The only way to know if a woman has this condition is through a surgical procedure to look inside the abdomen and pelvis, called a laparoscopy. Endometriosis cannot be seen on an x-ray, MRI or ultrasound. There are no blood tests that can make the diagnosis. Often a doctor will assume that a patient has the condition based on her description of her symptoms.
How is endometriosis treated?
Endometriosis is a chronic condition for which there is no cure. Treatment is designed to manage the symptoms. Your doctor will consider your age, overall health, symptoms and other factors when advising what treatment is best for you. Whether you hope to become pregnant will also play a role in your choices.
“Treatment choices include medicine, surgery, or both. If symptoms are mild, you may only need pain medicine. In other cases, hormone-based medicine, such as birth control pills, will stop ovulation and slow endometriosis,” said Dr. Hill.
Surgery is used to officially diagnose endometriosis. During surgery, areas of endometriosis can be burned off. However, since endometriosis is hormonally driven, it will grow back unless a hormonal treatment is also done. For women with severe disease, removal of the uterus (hysterectomy) and ovaries is also a choice.
What are possible complications of endometriosis?
In some cases, endometriosis can make it harder to become pregnant. However, most women will be successful with IVF.
Living with endometriosis
Simple steps that can help ease the pain of endometriosis include:
- Rest, relaxation, and meditation
- Warm baths
- Prevent constipation
- Regular exercise
- Use of hot water bottle or heating pad on your belly
To find a PIH Health OB/Gyn doctor, visit PIHHealth.org/OB.