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The American College of Obstetricians and Gynecologists (ACOG) estimates that one in 10 females of reproductive age will develop endometriosis. There are no known causes or proven cures, and many live with pain for years before being diagnosed.
Understanding Endometriosis
Most often identified in women in their 30s and 40s, endometriosis occurs when tissue resembling the uterine lining grows outside of the uterus where it does not belong—implanting on the ovaries, fallopian tubes, and other parts of the pelvis. Less often, the disease affects the bladder, bowels, and other areas.
Endometriosis reacts to hormonal changes, thickening and shedding a sticky substance. But, unlike the uterine lining, which exits the body when you menstruate, this tissue is trapped inside the body. With nowhere to go, the tissue grows, leading to scarring, inflammation, and hormonal changes, according to Dr. Scott Dinesen, an OB/GYN who treats the disorder. Sometimes, scar tissue binds organs together.
Symptoms include
- Painful periods
- Bloating
- Nausea
- Lower back or pelvic pain
- Painful intercourse
- Infertility
Endometriosis makes it harder to become pregnant. The American Society for Reproductive Medicine estimates that 30% - 50% of women with endometriosis may have infertility. However, with treatment, many conceive and carry a pregnancy to term.
Endometriosis Without Symptoms
"Endometriosis doesn't always cause symptoms. We sometimes discover the condition during infertility treatment or an unrelated surgery," says Dr. Dinesen.
Is it Period Pain or Endometriosis?
Normal period pain should not take you out of commission or last more than a few days. "Endometriosis is just one of several potential causes of painful periods," says Dr. Dinesen. "Not everyone with endometriosis will experience pain. And not everyone with painful periods has endometriosis."Talk About Your Symptoms
You should see your healthcare provider if you have severe period pain or signs of endometriosis. Never assume your pain is normal. Your doctor will ask about your medical history and symptoms and complete a pelvic exam to check for scar tissue and cysts. "This can result in a reasonable diagnosis in many cases," explains Dr. Dinesen. He notes that laparoscopic surgery is the only definitive way to diagnose endometriosis.Managing Symptoms
We don't have a cure for endometriosis, but effective treatments are available. According to Dr. Dinesen, whether you have painful periods or endometriosis, pain medicines, and hormone therapy are the first line of treatment. However, surgery to identify and treat endometriosis may be necessary if symptoms continue to affect a person's quality of life.Other treatments include:
- Anti-inflammatory medications (NSAIDs) like ibuprofen
- Birth control pill
- Gonadotropin-releasing hormone (GnRH) agonists that influence estrogen and progesterone production
- Pelvic floor therapy can help treat pelvic floor muscles that have tightened. This tightening is often a response to the pain caused by inflammation
When Surgery is Needed
Specialized instruments and a tiny camera inserted through small incisions allow your doctor to examine your abdominal cavity on a video screen.
"Taking a look inside the abdomen using minimally invasive laparoscopy is a possible solution when medical therapy is not working, if infertility is involved, or if a diagnosis is unclear, says Dr. Dinesen. "We can look for abnormal tissue, collect a sample for testing, and simultaneously remove endometriosis."
Your doctor may also suggest robotic surgery, which expands on what surgeons can do laparoscopically. Both have similar outcomes and use small incisions and a miniature camera. "The robot allows surgeons to work precisely in areas of the body other minimally invasive techniques cannot reach. The platform offers enhanced views and a finer touch for advanced endometriosis with significant scarring.
More information is available by visiting ACOG’s FAQs about Endometriosis.
About Doylestown Health
Doylestown Health is a comprehensive healthcare system of inpatient, outpatient, and wellness education services connected to meet the health needs of the local and regional community. The flagship of Doylestown Health is Doylestown Hospital, a not-for-profit, community teaching hospital with 247 beds and a medical staff of more than 435 physicians who provide the highest quality care in over 50 specialties. Renowned locally, regionally, and nationally, Doylestown Hospital provides superior healthcare and offers advanced surgical procedures, innovative medical treatments, and comprehensive specialty services. Now in its 100th year of service in central Bucks County, Doylestown Hospital is proud to educate and train the next generation of physicians through its family medicine residency program. Ranked as one of the World’s Best Hospitals by Newsweek and 8th in Pennsylvania, Doylestown Hospital is distinguished in both infection prevention and patient experience. Doylestown Hospital is the only hospital in Pennsylvania to achieve 16 consecutive ‘A’ grades for patient safety from Leapfrog Hospital Safety Grade.
Doylestown Health Obstetrics and Gynecology
Doylestown Health's expert OB/GYN physicians and certified nurse midwives provide skilled and compassionate health care throughout all stages of a woman's life, from adolescence through menopause and adulthood. And for families welcoming new babies, Doylestown Health's VIA Maternity Center offers labor, delivery and postpartum care in a state-of-the-art, family-centered facility — complete with a Level II Neonatal Intensive Care Unit staffed round-the-clock by CHOP neonatologists.
