Understanding Endometriosis

Unless you or someone you know has endometriosis, it’s likely a condition you’ve heard of but don’t know much about. The sad truth is that a lot of the symptoms of endometriosis—namely, pain associated with menstruation—have become normalized. Women expect their period to cause pain and are therefore unlikely to speak up or even realize if the pain they’re experiencing is abnormal. Healthcare providers also tend to categorize symptoms as “normal” for menstruating women.

Altogether, these factors often lead to the underdiagnosis or delayed diagnosis of endometriosis. This is why women need to be educated about what endometriosis looks like, what to do if you suspect it, and how to manage a diagnosis. Let’s look at this condition that affects roughly 10% of reproductive-age women and girls globally.

What Is Endometriosis?

Endometriosis is when tissue similar to the tissue that lines your uterus grows in other places. This is the same tissue lining shed during your period, called the endometrium. Endometrial tissue can grow virtually anywhere in the body but most often moves to the lower abdomen and pelvic areas (ovaries, fallopian tubes, bowel).

There are four stages of endometriosis: minimal, mild, moderate, and severe. The stage reflects the size and extent of the endometrial lesions, but it does not determine the severity of the symptoms.

What Are the Symptoms of Endometriosis?

Some women with endometriosis don’t have any symptoms. When they do experience symptoms, the most common one is pain. Other common symptoms include:

Long, heavy, and/or painful periods
Lower abdominal pain that is constant or worsens before and/or during menstruation
Pain during intercourse
Pain during urination or bowel movements
Bleeding in between periods
Lower back pain
Digestive problems (nausea, vomiting, constipation, diarrhea)
Chronic fatigue
Infertility

If you are experiencing any of the above symptoms, inform your gynecologist so they can determine which next steps might be necessary.

How Is Endometriosis Diagnosed?

Your doctor will usually suspect endometriosis based on your symptoms. In this case, they will likely perform a pelvic exam to check for abnormal pain, scarring, cysts, or nodules. An ultrasound can help rule out other pelvic issues and sometimes indicate the presence of endometrial lesions.

However, the only definitive way to diagnose endometriosis is through surgery. Your doctor will perform a laparoscopy, a minimally invasive method of inserting an instrument into the abdomen that allows them to inspect the area. They will look for visible endometrial implants or lesions and may biopsy the tissue to confirm.

How Is Endometriosis Treated?

Unfortunately, there is no cure for endometriosis. Symptoms can be managed and treated so as not to impact your daily life. Over-the-counter pain medications, such as ibuprofen, can be used to manage painful cramps. Hormonal birth control and other hormone therapies can also help alleviate symptoms by preventing the buildup of endometrial tissue.

In some cases, your doctor may prescribe a medication that stops the production of estrogen, such as Gonadotropin-releasing hormone (GnRH) agonists and antagonistsor Danazol, essentially sending your body into a state of artificial menopause.

If your pain is severe or you are trying to conceive, you may also be treated with surgery to remove or destroy endometrial growths. Usually, this is done via laparoscopy, the same type of outpatient procedure used to diagnose the condition.

At South Avenue Women’s Services, we provide full-service, well-woman care. If you’re experiencing concerning symptoms or have questions about endometriosis, our women’s healthcare specialists are here to help and provide the information you need to take your next step.