Endometriosis is the presence of endometrial tissue (tissue that lines the inside of the uterus) on the outside of the uterus. The most common sites for growth are the ovaries, fallopian tubes, lining the inside of the pelvic cavity, cervix, bladder, bowel, liver and lungs. Approximately 33% of women who suffer from chronic pelvic pain are found to have endometriosis. It is also found in 20-40% of women with infertility. Caucasian race, early onset of menarche, short menstrual cycles, and a first degree relative with endometriosis are all risk factors related for this disorder.
Presenting symptoms vary from patient to patient. Symptoms may increase in severity over time. The most common symptoms include pain during menses, pain with intercourse, pelvic pain, infertility, diarrhea, constipation and painful bowel movements. Abnormal uterine bleeding such as long and heavy flow periods have also been reported. There are no lab tests that can be done to diagnose the disorder. The best way to diagnose endometriosis is based off symptom response to treatment or laparoscopic confirmation of tissue presence outside the uterus. Since the latter of the two options is invasive, your provider may choose to treat without a confirmation biopsy.
Most symptoms related to endometriosis are caused by the actual growth of endometrial tissue outside the uterus. This tissue grows in response to the fluctuations of hormones during the menstrual cycle. Since a woman repeats her menstrual cycle throughout most of her lifespan, treatment should be individualized based on desire for children and symptom management. Ovulation suppression to prevent the fluctuation of hormones results in sustained growth of endometrial tissue. This is one of the easiest and most common treatments for endometriosis and can be done with oral contraception or other medications such as Lupron®. Injectable contraception and intrauterine devices can also be used. Surgical removal of the uterus can be an option for those who no longer wish to have children and have failed other treatments. For those patients trying to conceive while suffering from endometriosis, our office can offer an individualized treatment plan to fit your reproductive needs. If you would like to discuss endometriosis or any symptoms you are having, please contact the office for an appointment with a provider.