Endometriosis

Endometriosis is a common condition that may affect women during their reproductive years. Because this issue relates to infertility, it is an important topic for women’s health.

What Is Endometriosis?

Endometriosis is a gynecologic condition in which tissue cells that normally make up the inner lining of the uterus grows outside of this structure.

Why This Growth Is Problematic

The tissue that becomes implanted on the outer wall of the uterus continues to respond to estrogen. This means that it will grow and bleed in the same manner as internal uterine tissue. Irritation, inflammation, and swelling may result, as can adhesions, or scar tissue. The presence of adhesions creates a potential for organs to stick to one another. It also increases pain associated with menstruation.

The condition is also cited in approximately 40% of infertility cases in which the female partner cannot conceive. It is thought that infertility may stem from inflammation which blocks the movement of the sperm and the egg through the fallopian tubes to the uterus.

Endometriosis Symptoms

Pelvic pain is one of the primary indicators of endometriosis. Because most women experience some degree of cramping associated with menstruation, this can be a difficult symptom to fully understand. For some women, mild endometriosis can cause substantial pain. For others, minimal, if any pain may occur even with advanced endometriosis. Therefore, pain is not the best gauge for recognizing an underlying problem as endometriosis.

Additional symptoms that may alert you to abnormal uterine growth include:

• Lower back or abdominal pain that lingers several days into menstruation.
• Painful intercourse.
• Painful urination or bowel movements.
• Heavy menstrual bleeding or bleeding in between periods.
• Infertility
• Excessive bloating, nausea, constipation, diarrhea, or fatigue during menstruation.

If you experience any of these symptoms or other irregularities related to your cycle, schedule a consultation and exam with your healthcare provider. With an early diagnosis and a good understanding of your condition, endometriosis can be manageable.

Endometriosis Diagnosis

Gynecologists perform specific tests to discern the cause of pelvic pain and other menstrual irregularities. Diagnostic evaluation begins with a thorough medical history to assess risk factors and to characterize the condition based on the particulars of symptoms. In addition to a comprehensive history, physical diagnostics may also be necessary.

• A pelvic examination involves external and internal palpation through which abnormalities may be felt. Typically, this method of examination is better at recognizing cysts or scarring. Small areas of endometriosis may not appear on a pelvic exam alone.
• Imaging obtained with high-frequency sound waves facilitates observation of the uterus and other pelvic organs. This diagnostic test can alert the health care provider to the presence of cysts, but it does not definitively confirm endometriosis.
• Laparoscopic surgery is both diagnostic and therapeutic in many cases. This procedure enables the gynecologist to view the outer lining of the uterus using a small instrument. Your gynecologist may obtain tissue samples at the same time and, in some cases, remove endometrial implants.

Endometriosis Treatment

Endometriosis treatment varies based on each patient’s situation. Conservative non-surgical treatments are generally attempted first. These may include:

• Over-the-counter pain medication to control menstrual cramping.
• Hormone therapies to inhibit the reactivity of endometrial growth after ovulation. Such treatments also prevent ovulation and menstruation, both of which return after stopping medication.
• Laparoscopic surgery to remove endometrial tissue on the outside of the uterus. A woman may still become pregnant after this conservative surgical procedure. Because the ovaries remain intact, pain may also return sometime after existing endometrial implants have been removed.
• Total hysterectomy may be necessary to resolve severe endometriosis. Because the removal of the uterus, ovaries, and cervix disable reproductive capabilities, this treatment is a last resort, especially during the reproductive years.

Does Endometriosis Cause Infertility?

It is true that endometriosis is associated with infertility in women. However, early and proactive treatment for this condition can have a positive effect that enables a woman to have a healthy and successful pregnancy.