Endometriosis: What you should know

Do you have very painful cramps or periods, heavy periods, chronic pelvic or lower back pain, pain during or after sex, or infertility? If so, you could have endometriosis!

Endometriosis is one of the most common things that I deal with. Symptoms vary as some women have no symptoms while others have symptoms severe enough that it affects their lives. Others may not find out that they suffer from the disease until they have difficulty getting pregnant. About 30-40% of women with endometriosis are infertile, making it one of the top three causes of female infertility!

How do you get endometriosis? There are many theories, the most common being retrograde flow. When you get your period, the blood and lining from the uterus sheds and comes out of the vagina. But some of that blood and tissue goes through the opening for the fallopian tubes (located in the uterus) back into the body. This tissue can attach and grow in sites that it’s not supposed to be.  Another theory about endometriosis involves genes; that endometriosis is inherited. It is true that if your relatives have endometriosis, you are at greater risk of having it. Still another theory is that it is related to your immune system.

There are tests that your doctor can perform to find out if you have endometriosis. Sometimes an imaging test such as an ultrasound or a MRI is used to produce a “picture” of inside the body, which allows us to find larger endometriosis areas such as nodules or cysts. However, the only way to know for sure if you have endometriosis is by having surgery called laparoscopy. Your doctor will only do a laparoscopy after getting a complete medical history, doing a full physical and pelvic exam, and obtaining imaging studies. In this procedure, the surgeon makes a small cut in the abdomen and inflates the abdomen with a harmless gas. The surgeon can then insert a small instrument called a laparoscope to look at the reproductive organs, intestines, and other surfaces to see if there is endometriosis. The diagnosis is made by the characteristic appearance of endometriosis or by doing a biopsy. Many times, treatment can be done at the time of diagnosis. A laser or heat can be used to fulgurate (burn) the visible areas of endometriosis.

Currently we do not have a cure for endometriosis. However, there are a number of treatments for both the pain and for infertility. These include hormonal therapy, surgical treatment, and pain medication.  If you have any of the symptoms or have any questions, please talk with your health care provider.

Do I have an STD?

When I see patients in the office, one of the most frequently asked questions is “How do I know if I have an STD?” The simple answer is “Get tested!” but if you want a basic guide to the most common STDs, this is just the place!

First up, chlamydia! Chlamydia is the most frequently reported sexually transmitted bacterial infection. It is contracted by having anal, vaginal, or oral sex with someone who has the infection and despite popular belief, it CAN be transmitted even if the male does not ejaculate! 

Some infected women do experience:

·         Abnormal vaginal discharge

·         Burning with urination

·         Rectal pain

·         Rectal discharge

·         Rectal bleeding

Although the above mentioned symptoms are possible, chlamydia is commonly known as a “silent” infection because a large number of people infected have no symptoms.  In addition, even if symptoms appear, they may not occur until weeks after exposure.

Another common STD is gonorrhea. Gonorrhea is also contracted by having anal, vaginal, or oral sex with someone who has the disease. Like chlamydia, gonorrhea can also still be transmitted even if the man doesn’t ejaculate.

Symptoms of gonorrhea can include:

·         Burning with urination

·         Increased vaginal discharge

·         Vaginal bleeding between periods

However, most women with gonorrhea have no symptoms! Even when a woman has symptoms, often they are mild and are confused for bladder or vaginal infections.

Don’t be fooled by a lack of symptoms! Even without symptoms, chlamydia and gonorrhea can damage a woman’s reproductive organs. If left untreated, they can spread up to the uterus and fallopian tubes and cause pelvic inflammatory disease (PID). PID can have no symptoms or cause abdominal or pelvic pain.  PID with or without symptoms can lead to infertility or other complications. 

In addition, gonorrhea can spread to the blood or joints and become life threatening! Anyone who is sexually active should talk to their health care provider about being tested. There are simple tests to diagnose chlamydia and gonorrhea and once diagnosed can be cured with antibiotics.

The most common curable STD is trichomonas, also known as “trich.” It is more common in women than men, and older women are more likely to have trich than younger women to be infected.  Like the other STDs, it is transferred from one person to another during sex.

Symptoms in women can include:

·         Genital itching

·         Genital burning

·         Genital redness

·         Genital soreness

·         Discomfort with urination

·         Vaginal discharge with a smell

In addition, trichomonas can make it feel unpleasant to have sex. If left untreated, it can last from months to years! Trich can be diagnosed with a simple test and treated with a single dose of antibiotic.

Although incurable, another very common STD is genital herpes. Herpes is very prevalent in the United States. Amazingly, it is estimated that nationwide, one out of every six people aged 14-49 has genital herpes!  Like the other STDs, most people with genital herpes have no symptoms or very mild symptoms. Because of this, most people that have herpes are unaware that they have it. 

When symptoms do occur, they typically appear as blisters around the genitals, mouth, or rectum. The blisters break and become painful sores. This is known as an outbreak and repeat outbreaks are common. 

Herpes is contracted by having vaginal, anal, or oral sex with someone who has the disease. Even though herpes is found in and released from the sores, the virus can also be transmitted from skin that does not appear to have a sore.  Herpes can be transferred to other parts of the body by touching the sores and end up sometimes in sensitive places such as the eye. There are cultures and blood tests for herpes.  Although herpes is not curable, it is a manageable condition.

As you can see, many of the people with four of the most common STDs HAVE NO SYMPTOMS. Left untreated, many of these can have a significant and long lasting detrimental effect on your health and fertility. So do yourself a favor, set up an appointment with your health care provider to discuss your risk and GET TESTED!