What Is Endometriosis and How Can You Treat It?
Find out what endometriosis is, how it can affect fertility, and how to treat it.
Sanaz Majd, MD
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What Is Endometriosis and How Can You Treat It?
I recently had one of my listeners ask me a question I get asked a lot. She wanted to know the best way to treat endometriosis.
This topic is a popular one, mostly in women who want to become pregnant. So I would like to dedicate today’s episode to endometriosis.
What Is Endometriosis?
The lining of the uterus, or what’s often referred to as the endometrium, is made up of unique glands and tissue. In women with endometriosis, small areas of this endometrial tissue actually grow outside the uterus, such as in the ovary, fallopian tubes, ligaments of the pelvis, colon, appendix, or really anywhere within the pelvis.
We don’t know why some people get this outside growth and some people don’t, but genetics seems to play a role. We do know, however, that the deeper these spots are located, the more severe the symptoms tend to be.
What Are the Symptoms of Endometriosis?
You may be thinking, “So who cares whether you have a few extra bits and pieces of endometrial tissue here and there?” The more the merrier, no? Well…not quite. Most women who suffer from endometriosis will tell you that it’s no walk in the park. In fact, many of the symptoms can be quite painful. Here are the most common symptoms of endometriosis:
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Pelvic cramping and pain with periods
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Chronic pelvic pain
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Pain with intercourse
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Low back pain
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Cyclical diarrhea, constipation, or bloating (if located near the bowel)
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Irregular menstrual bleeding
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Difficulty getting pregnant
How Is Endometriosis Diagnosed?
Depending on the location of the spots, your doctor may be able to feel the abnormal growths during your pelvic exam. But that is not too common. The best and only good way to diagnose endometriosis is to actually see the abnormal tissue. How would a doctor do that? Well, you’d have to be placed under general anesthesia and have a procedure called an exploratory laparoscopy. In that procedure, a few small holes are created in the abdomen and a camera is inserted to look inside. If the abnormal growths are found, they are typically destroyed during the procedure.
How Is Endometriosis Treated?
There are various ways to treat endometriosis, and the goal of treatment is to improve symptoms and/or improve problems with fertility. Here are the main treatment options.
Hormonal contraceptives: If a woman is not trying to get pregnant, a hormonal contraceptive is a good treatment choice to keep the outer growths in check. You have a number of options:
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Continuous pill: Sometimes, if it’s severe enough, taking the continuous form of the pill that gives you a period c once every three months only is a good option.
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Injection: The other possibility is to get the hormonal injection given once every three months that also diminishes periods. Those who use the injection eventually either stop their periods or get very minimal amount of bleeding, and hence, the endometriosis symptoms go away.
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The hormonal IUD: Like the injectable hormonal contraceptive, the hormonal IUD (please refer to my previous podcast to learn more about the IUD types) will minimize or completely stop periods after the first six months of insertion.
Anti-Inflammatories: Anti-inflammatory pain medications may provide some relief to patients who suffer from endometriosis. These medications include prescription ibuprofen, along with many others.
Menopause: Endometriosis symptoms usually abate and even resolve after menopause, once estrogen levels decline. So for those women whose symptoms are mild or controllable, there is a light at the end of the tunnel if you can just hang in there. There is also a medication, called danazol, which induces a pseudomenopausal state, but this is used as a last resort for those in great misery.
Surgery: No one wants to have surgery done. And even though it’s the best way to get a more accurate diagnosis (and treatment, for that matter), it is usually not performed unless the symptoms from the endometriosis are absolutely uncontrollable with other treatments, or, unless there is an issue with infertility. If endometriosis is suspected, surgically zapping those abnormal endometrial spots will make it much easier for a woman to get pregnant. The same procedure that’s often used to diagnose endometriosis—a laparoscopy—is used. But again, this should be very last resort.
And as for the woman who initially asked me about treatment for endometriosis–when I returned her email, she revealed that she her endometriosis was cured by surgery and she was indeed pregnant! I love happy medical stories like this one, and have seen this happen in other women with endometriosis on other occasions. So if you have endometriosis, take heart.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Uterus image courtesy of Shutterstock