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.