Endometriosis is a chronic and typically painful condition in which tissue that normally lines your uterus grows outside the uterus. These areas of abnormal tissue usually are found on the lining the pelvic wall (peritoneum), fallopian tubes, ovaries, or the outer surfaces of the uterus, bladder, ureters, intestines and rectum. This tissue may grow and bleed like the uterine lining does during your menstrual cycle resulting in inflammation and irritation of tissue causing scar tissue (adhesions), pain and even infertility.
The exact cause of endometriosis is not currently known and appears complex. It is primarily thought to be caused by menstrual blood being pushed back through the fallopian tubes and attaching to the pelvic wall and surrounding surfaces.
The diagnosis of endometriosis is difficult because of the variety and degree of symptoms. The most common symptom of endometriosis is chronic pelvic pain, especially right before and during your menstrual cycle. Other symptoms may include painful intercourse, heavy menstrual bleeding, discomfort with bowel movements and during urination, and infertility.
There is no cure for endometriosis so the goal of treatment is to help relieve symptoms and prevent future complications. When pain is the primary symptom, medication is usually tried first. Medications that may be prescribed include non-steroidal anti-inflammatory drugs (NSAIDs), hormonal medications like birth control pills, progestin-only medications like an intrauterine device and gonadotropin-releasing hormone agonists. Hormonal medication may help slow the growth of endometrial tissue and thus prevent inflammation and adhesions. These drugs typically do not get rid of endometriosis that is already there. In this scenario, surgical treatment, usually by laparoscopy, may help remove endometriosis tissue. As a last resort, hysterectomy may be discussed.
According to ACOG, 4 in 10 women with infertility have endometriosis. Endometriosis can make getting pregnant more difficult because adhesions can distort normal anatomy, cause scar tissue to fallopian tubes, and create an inflammatory environment damaging egg quality and preventing implantation. Based on your age and severity of endometriosis, a referral to a reproductive specialist may be recommended.
Being aware of symptoms and seeking medical advice from your Gynecologist may allow for early diagnosis and treatment. When we share our personal stories and discuss available treatment options, women may feel empowered to reach out for more information which could lead to further advances in treatment and eventually a cure.