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Endometriosis: Caring for the Most Common Gynecological Disease

You’ve been experiencing pain – before your period, during your period, and perhaps during or after sex. It’s important to check in with your AOA physician to determine exactly what is causing this pain. It could be endometriosis. With more than 5.5 million women in the United States and Canada being diagnosed, endometriosis is one of the most common gynecological diseases. It can affect any menstruating woman, from the time of her first period to menopause, regardless of whether or not she has children, her race or ethnicity, or her socio-economic status. Endometriosis can sometimes even persist after menopause; or hormone replacement therapies may cause the endometriosis symptoms to continue.

Endometriosis: Caring for the Most Common Gynecological Disease

What is Endometriosis?
Endometriosis occurs when tissue, like that which lines the inside of uterus, begins growing outside the uterus, usually on the surfaces of organs in the pelvic and abdominal areas, in places where it is not supposed to grow. Your doctor may call these areas of endometriosis by different names, such as implants, lesions, or nodules.

The most common symptoms of endometriosis is pain, mostly in the abdomen, lower back, and pelvic areas; however, the amount of pain you may feel is not linked to how much endometriosis you may have. Some women have pain before and during their periods, or during or after sex. The pain can be so intense that it impacts their quality of life and their relationships. Some women, however, have no pain even though their endometriosis is extensive, meaning that the affected areas are large, or that there is scarring. Others have severe pain even though they have only a few small areas of endometriosis. Your AOA doctor can determine the extent of the condition and can help identify your best options for finding relief.

Symptoms
Symptoms of endometriosis can include (but are not limited to):

  • Extremely painful (or disabling) menstrual cramps, which may get worse over time
  • Chronic pelvic pain (includes lower back pain and pelvic pain)
  • Pain during or after sex
  • Intestinal pain
  • Painful bowel movements or painful urination during menstrual periods
  • Heavy menstrual periods
  • Premenstrual spotting or bleeding between periods
  • Infertility

In addition, women who are diagnosed with endometriosis may have gastrointestinal symptoms that resemble a bowel disorder, as well as fatigue.

How will having endometriosis affect my ability to have children?
About 30 percent to 40 percent of women with endometriosis are infertile, making it one of the top three causes of female infertility. The two most frequent symptoms of endometriosis are pain and infertility. Some women have no symptoms and may not learn that they have the disease until they have trouble getting pregnant.

The relationship between endometriosis and infertility is an active area of research. Some studies suggest that the condition may change the uterus so it does not accept an embryo. Other work explores whether endometriosis changes the egg, or whether endometriosis gets in the way of moving a fertilized egg to the uterus.

If you are experiencing regular pain associated with your period or with sexual intercourse, it is important to make an appointment to talk with your AOA physician.

Treatment for Endometriosis
There is no cure for endometriosis, but depending on your age, the severity of your symptoms, your desire for children, and your overall state of health, there are treatments that include pain medication, hormone therapy and surgery.

Pain medication can help relieve your symptoms if they are mild. These can range from over-the-counter medication to stronger prescription drugs.

Because hormones cause patches of endometriosis to go through cycles in conjunction with menstrual cycles, hormone therapy can effectively relieve pain related to endometriosis. This therapy usually comes in the form of nasal sprays, injections or a pill. Hormone treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation. This can potentially slow the growth of endometrial lesions, but it will not make adhesions go away.

If your pain is very severe, your AOA physician may recommend a surgical treatment. This can include a laparoscopy, which involves making one or two small cuts in the abdomen to insert lasers and other surgical instruments to remove lesions either by excising them or by cauterizing, which seals the blood vessels with intense heat.

Another, more major surgical procedure is a laparotomy. This is major abdominal surgery during which the surgeon may remove the endometriosis patches. It may also involve removing the uterus. In severe cases, the surgeon may need to also remove the ovaries and the fallopian tubes along with the uterus. When at all possible, the surgeon prefers to leave the ovaries in place, since they play an important role in overall health.

Again, if you are experiencing pain in conjunction with your menstrual cycle, or during or after sex, it is important to consult with your AOA physician to determine the cause of your pain, and to get on a course of appropriate treatment.

Learn more about endometriosis symptoms and treatments: