The inner lining of the uterus (called the endometrium) is made up of endometrial tissue. This tissue normally builds up during the menstrual cycle, and it is shed each month during the menstrual period. Endometriosis occurs when this tissue grows outside the uterus in places such as the fallopian tubes or the ovaries. Rarely, the tissue may grow in other areas of the body. The disorder can affect females between puberty and menopause. It is most common between ages 20 and 30.
FREQUENT SIGNS AND SYMPTOMS
Symptoms may begin suddenly or develop over years.
Pelvic pain that may occur at anytime. It may increase during menstrual periods, especially the last days.
Pain with sexual intercourse.
Premenstrual spotting, blood in the urine, or blood in the stool (sometimes).
Unknown. One theory is that, during menstruation, some of the menstrual tissue backs up through the fallopian tubes into the abdomen, where it implants and grows. Another theory is that endometriosis may be genetic, or that certain families may experience risk factors that lead to endometriosis. The body's immune system may also play a role in the cause.
RISK INCREASES WITH
Women who don't become pregnant or who delay childbirth.
Women with family history of endometriosis.
Medical conditions that involve the cervix or vagina.
There are no specific preventive steps.
It is an ongoing, long-term disorder that may get worse over time. Symptoms can often be relieved with treatment. Women with severe disease may have less success with treatment. The ability to become pregnant depends on factors such as severity of the disorder and success of treatment.
Severe pain that causes depression, stress, and problems with daily living activities.
Adhesion (scar tissue) of pelvic organs.
Endometriosis can recur after treatment.
Cysts and pelvic masses called endometriomas.
An increased risk of cancer is a possibility.
DIAGNOSIS & TREATMENT
Your health care provider will do a physical exam and a pelvic exam. Medical tests may include laparoscopy. A thin, lighted tube (called a laparoscope) is inserted through a small incision (cut) in the abdomen to view internal organs and to (sometimes) remove tissue. Open surgery, called laparotomy, may be needed for diagnosis.
Treatment may include drugs, surgery, or both. Alternative treatments (such as acupuncture) may help. Treatment will vary depending on the severity of the disease and the patient's age and desire for pregnancy. A patient may desire pregnancy now, at a later time, or not at all.
Different procedures are used for treatment. The options will be explained to you. A hysterectomy may be suggested for women who do not desire pregnancy.
Use a heating pad or take warm baths to relieve pain. Cold therapy may help. Use ice packs on the abdomen.
Put a pillow under your knees when you rest or sleep. When lying on your side, pull the knees up to the chest.
You may use nonprescription drugs, such as nonsteroidal, anti-inflammatory drugs, to relieve minor pain.
Stronger pain relievers may be prescribed.
Hormonal drugs to stop ovulation may be prescribed.
Exercise, such as walking, may help to relieve pain.
You may be taught to do Kegel exercises to help strengthen the pelvic floor muscles.
Avoid alcohol and caffeine, as they can make the pain more severe in some women.
NOTIFY OUR OFFICE IF
You or a family member has symptoms of endometriosis.