Endometriosis is a common gynecological condition, particularly among women of childbearing age, affecting an estimated 2 to 10 percent of American women in this age group. Endometriosis can be a debilitating disease for some women who experience ongoing pain, while others may not experience any symptoms. It is also a factor in infertility. According to the American Society for Reproductive Medicine, endometriosis can be found in 24 percent to 50 percent of women who experience infertility.
What is Endometriosis?
The name comes from the word "endometrium," which is the tissue that lines the uterus. During a woman's regular menstrual cycle, this tissue builds up and is shed if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle by building up and breaking down just as the endometrium does, resulting in internal bleeding.
Unlike menstrual fluid from the uterus which is shed by the body, blood from the misplaced tissue has nowhere to go, resulting in the tissues surrounding the endometriosis becoming inflamed or swollen. This process can produce scar tissue around the area which may develop into lesions or growths. In some cases, particularly when an ovary is involved, the blood can become embedded in the tissue where it is located, forming blood blisters that may become surrounded by a fibrous cyst.
Symptoms of endometriosis may include:
- pain, especially excessive menstrual cramps which may be felt in the abdomen or lower back
- pain during intercourse
- abnormal or heavy menstrual flow
- painful urination during menstrual periods
- painful bowel movements during menstrual periods
- other gastrointestinal problems (i.e., diarrhea, constipation, and/or nausea)
Diagnosis and Treatment of Endometriosis
Diagnosis begins with a gynecologist evaluating a patient's medical history and a complete physical examination including a pelvic exam. A diagnosis of endometriosis can only be certain when the physician performs a laparoscopy, a minor surgical procedure in which a laparoscope, a thin tube with a lens and a light, is inserted into an incision in the abdominal wall.
Treatment for endometriosis may include:
- "watchful waiting" - to observe the course of the disease
- pain medication - such as ibuprofen or other over-the-counter analgesics
- hormone therapy
- a combination of the above therapies