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Common disease takes aim at women
Women worldwide share common bond in battle against endometriosis
Endometriosis is a common disease affecting millions of women worldwide and about 15 percent of the reproductive-aged women in the United States. Typically associated with painful periods, evidence strongly suggests it may also lead to infertility.
What is endometriosis?
Endometriosis is a common health problem in women and gets its name from the word endometrium, the tissue that lines the uterus (womb). This tissue grows outside of the uterus in the form of growths, tumors, implants, lesions or nodules.
Every month, hormones cause the lining of a woman’s uterus to build up with tissue and blood vessels. If a woman does not get pregnant, the uterus sheds this tissue and blood and exits the body in the form of a menstrual period.
Endometriosis also responds to a woman’s monthly cycle. Each month the growths add extra tissue and blood, but there is no place for the built-up tissue and blood to exit the body. For this reason, growths tend to get bigger and the symptoms of endometriosis often get worse over time.
As the misplaced tissue grows, it can cover or grow into the ovaries and block the fallopian tubes, making it difficult for women with endometriosis to get pregnant.
What causes it?
No one knows for sure what causes this disease, but scientists have a number of theories. More research in this area may help doctors better understand and treat endometriosis.
We know that endometriosis tends to run in families. If your mother or sister has endometriosis, you are six times more likely to get the disease than other women.
You are also at greater risk of developing endometriosis if any of the following are true: started your period at an early age; heavy periods; periods longer than seven days; short monthly cycle (27 days or less); or have a close relative (mother, aunt, sister) with endometriosis.
While pelvic pain is the most common symptom, not every woman who has endometriosis has pain. Likewise, menstrual pain is not always the result of endometriosis. Symptoms can include:
• pain before and during periods;
• pain with sex;
• painful urination during periods;
• painful bowel movements during periods;
• gastrointestinal issues such as diarrhea, constipation, nausea.
While all are possible signs of endometriosis, they could also indicate other problems. If you suffer from any of the above you should see your doctor. While the cause of chronic or severe pelvic pain may be difficult to determine, discovering the problem early may help you avoid unnecessary complications and pain.
As stated earlier, infertility can also be a symptom of endometriosis. However, many women with mild to moderate endometriosis are able to conceive if treated early. Some doctors advise patients not to delay having children, as the disease tends to worsen with time. The longer you have endometriosis, the greater likelihood you will suffer from infertility.
While symptoms may strongly suggest the presence of endometriosis, the only way to know for sure is through a laparoscopic surgery. In this procedure, a tiny cut is made in your abdomen. A thin tube with a light is placed inside to see growths from endometriosis.
There is no cure for endometriosis, but there are treatments for the pain and infertility that it causes. These can include hormone therapy, surgery or a combination of both, depending on your symptoms, age, and plans for getting pregnant.
For mild symptoms, over-the-counter pain medication and/or hormone therapy is typically recommended. Hormone treatments manipulate the hormones that control menstruation and swelling of endometrial lesions.
Surgery is usually the best option for women who have several growths, severe pain or fertility problems. There are both minor and more complex surgeries that can help. Surgical treatments include:
• laparoscopy – used to diagnose and treat endometriosis. During this surgery, doctors remove growths and scar tissue or destroy them with intense heat.
• hysterectomy – should only be considered by women who do not want to become pregnant in the future.
Hormone therapy can also be used to augment surgery. Gonadotropin releasing hormone agonists, like Lupron, induce a temporary menopausal state which suppresses endometriosis and can be helpful when symptoms are not completely resolved with surgery.
Finally, if you think you have endometriosis, talk with an obstetrician/gynecologist, who is specially trained to diagnose and treat this condition.
Dr. Robert Gramann is a board-certified obstetrician/gynecologist and medical director with Enumclaw Medical Center.