Endometriosis

Endometriosis is more common than many people think. According to the National Institutes of Health (NIH), ten to twenty percent of American women may have endometriosis to some degree. For many of these women, the condition leads to increasing pelvic pain, painful menstrual periods, painful intercourse, excessively heavy periods and infertility. (Read about "Infertility")

Causes of endometriosis

In endometriosis, the type of tissue (called endometrium tissue) that normally lines the inside of the uterus attaches to other organs outside the uterus like the ovaries (Read about "The Ovaries"), pelvis and bowel. But, according to the American Academy of Family Physicians (AAFP), this tissue acts as if it were still inside the uterus; in other words, it builds up each month during a woman's menstrual cycle. The tissue also breaks apart and bleeds each month during a woman's periods. However, when this tissue is outside the uterus, it isn't easily discharged from a woman's body during her period; instead, it tends to remain in place and can cause swelling and inflammation to the surrounding areas.

Symptoms of endometriosis

The amount of inflammation and/or damage to the surrounding tissue and organs can vary from one patient to another. Depending on the extent of the damage, there are a number of different symptoms. According to the American College of Obstetricians and Gynecologists (ACOG), common symptoms include:

• pelvic pain or lower back pain
• excessive menstrual cramps known as dysmenorrhea (Read about dysmenorrhea in "Menstrual Disorders")
• irregular menstrual bleeding
• pain during or after sexual activity
• infertility which occurs in about a third or more of the women who have endometriosis and can develop as a result of the presence of endometriosis or the scarring and organ damage that may accompany endometriosis
• other changes in bowel or bladder habits before or during your period (Read about "The Urinary System")

ACOG says, however, that it's important to remember that these symptoms can also be a sign of other conditions. For example, pelvic pain can also indicate a urinary tract infection or interstitial cystitis. (Read about "Urinary Tract Infections" "Interstitial Cystitis") Pain during sexual activity can also be a sign of uterine fibroids or scar tissue. (Read about "Uterine Fibroids") Therefore, it's important to see your doctor or healthcare provider as soon as possible if you have pelvic pain, excessive bleeding or other suspicious conditions. In addition, according to ACOG, the amount of pain is not a good indicator of the extent of endometriosis; some women with little or no pain may have extensive endometriosis, whereas other women with severe pain may have a less extensive case.

Symptoms typically develop years after a woman starts getting her periods, according to NIH. As the years go by, the symptoms gradually tend to increase as the affected areas increase in size. With menopause (Read about "Menopause"), the abnormal growths of endometrial tissue shrink and the symptoms often subside.

Diagnosing and treating

If endometriosis is suspected, a doctor can perform a laparoscopy, a surgical procedure in which a laparoscope, which is a telescope-like device, is inserted into a small incision in the belly button. As the laparoscope is moved around the abdomen, the doctor can check the condition of the abdominal and pelvic organs and determine the location and size of the growths. (Read about "Endoscopy")

AAFP says that if the amount of growth is small or if the symptoms of endometriosis are mild or do not interfere with a woman's normal life, a doctor may decide that no treatment is necessary. If the condition is causing excessive pain or bleeding, hormonal therapy may be used. Surgery to remove the diseased tissue is also an option. In severe cases, removal of the uterus and/or ovaries may be required. (Read about "Hysterectomy") The surgery may be done conventionally or robotically. (Read about "Robotic Surgery") It is essential that a woman contact a surgeon experienced with the treatment of endometriosis.

Women who wish to become pregnant, and suspect they have been unable to do so because of their endometriosis, may need to discuss surgical options with their doctor. Endometriosis is considered one of the three major causes of female infertility, according to NIH. Pregnancy rates for patients with endometriosis remain lower than those of the general population. However, exactly how and to what extent endometriosis affects fertility is still not clear. Since endometriosis affects each woman differently, it's essential that there be good communication between a woman and her doctor.

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