Endometriosis

Q: What is endometriosis?

A: Endometriosis is a disease resulting in cells, which normally line the inside of the uterus (endometrium), being found outside of the endometrial lining in other areas of the body; most often on the ovaries, fallopian tubes, and surfaces of the uterus, bladder, and bowel. It is thought that these cells are transported to these sites when menstrual blood passes back out through the fallopian tubes into the abdominal cavity rather than all flowing out through the vagina during menstruation.

Q: Who is at greatest risk for endometriosis?

A: Endometriosis is most common among women in their 30s and 40s, but may occur in any woman who is menstruating. We do not see endometriosis developing in menopausal women.

Q: What are the symptoms of endometriosis?

A: The most frequent symptom of endometriosis is pain with menstrual periods called dysmenorrheal. Other symptoms include chronic pelvic pain; pain with intercourse; and pain with bowel movements. (The severity of pain does not necessarily correlate with the severity of disease.) Some women with this condition may experience irregular menstrual periods. Endometriosis is also associated with infertility, although the medical community has yet to uncover the precise connection. It is also possible to have endometriosis and have no symptoms at all.

Q: How is endometriosis diagnosed?

A: Although you may be told that your clinical findings and symptoms are "consistent with" endometriosis, the disease can only be accurately confirmed by visualizing the involved tissue. To do this, doctors will usually conduct a laparoscopy, a procedure that involves introducing a lighted endoscope into the abdominal cavity to look directly at the pelvic and abdominal organs while the patient is under a general anesthetic.

Q: Can endometriosis be treated?

A: The selection of a treatment method will depend on the severity of your symptoms, the severity of disease, and your desire for future childbearing.

Anti-inflammatory drugs such as ibuprofen (NSAIDS) may be used to decrease the pain. Oral contraceptives (birth control pills) may be used to slow the development and growth of endometrial implants and possibly new adhesions (scar tissue). Once endometriosis is diagnosed we may recommend medical therapy with birth control pills; Danazol, an injectable medication that lowers estrogen and progesterone levels; or Lupronan injectable medication which has the same effect on the production of estrogen and progesterone. The latter two medications can only be administered for up to 6-9 months due to their long-term effects.

If the symptoms do not improve we will often suggest that you consider laparoscopy to document the presence and severity of disease. At the time of laparoscopy, we can laser or cauterize endometrial implants and cut adhesions, as well as determine whether your fallopian tubes are normal. If one ovary is severely involved with endometriosis, it may be removed laparoscopically as a surgical, outpatient procedure. Among women who have completed their childbearing, removal of the uterus and often the ovaries and fallopian tubes may be recommended. Sometimes both ovaries do not have to be removed, avoiding a need for menopausal therapy at that time.

If you have any of the symptoms of endometriosis be sure to bring this to the attention of one of the providers at Women's Care Center. We provide diagnostic procedures and treatments, both medicinal and surgical, for this disease, which has the potential to cause severe disability to women.