As many as 5.5 million women in North America experience symptoms of endometriosis, a chronic gynecological disease that ranks as one of the top three causes of infertility in women.
Though there is no known cure, a combination of hormone therapy and surgery can reduce infertility and decrease the severity of painful symptoms related to endometriosis.
Endometriosis occurs when the endometrial tissues that line the uterus begin to grow outside the uterus. The abnormal growth of these tissues can cause pain as the body cannot expel menstrual blood cells and tissue as it normally would during the cycle. Most women with the condition are diagnosed after persistent symptoms for two or more years. Endometriosis causes abdominal cramping, pelvic and lower back pain, heavy periods, and has been linked to increased infertility rates.
Only a doctor with access to advanced tools, including laparoscopy, ultrasound, and magnetic resonance imaging (MRI), will be able to diagnosis endometriosis and develop an appropriate treatment plan.
Little is known about the causes of endometriosis. Researchers have explored multiple theories which, alone or in combination, may cause endometriosis. Some research centers on a possible link between heredity and endometriosis. For example, doctors believe women who have a family history of endometriosis are more likely to develop the disease. Other studies involve the connection between immunity, environment and the body’s response to tissues growing outside the uterus. Regardless of theories being explored, it is widely believed that higher levels of the hormone estrogen contribute to endometriosis; therefore symptoms are most severe during a woman’s peak childbearing years, and tend to diminish just as periods stop with the onset of menopause.
There is no known cure for endometriosis, but there are many approaches to care and treatment that can ease the discomfort associated with symptoms. For mild symptoms, your doctor may recommend an over-the-counter anti-inflammatory (NSAID) or pain-relieving medication, either alone or in conjunction with specialized hormone therapy. A non-drug treatment is laparoscopy, a minor, outpatient surgical procedure used to diagnosis and remove endometrial growths. A minor incision is made in the abdomen, and doctors are able to view internal organs and the presence of endometriosis outside the uterus. In some unusual cases, a hysterectomy (surgical removal of the uterus) may be considered as a last resort, only for women who have no plans to become pregnant, and whose endometriosis has already damaged the reproductive organs. Some studies suggest that regular exercise and avoiding excessive caffeine consumption can reduce the risk of developing endometriosis and may help manage symptoms in some patients.
If you have endometriosis, occasional episodes of severe pain may cause you to cancel social activities, interfering with relationships or frustrating your plans. While there is no cure, there are many ways to lessen the impact of endometriosis symptoms, allowing you to continue activities that contribute to a satisfying, enjoyable life.
If your symptoms are not severe, you may be able to keep discomfort from interfering with your life through awareness of your menstrual cycle and careful use of anti-inflammatory medications. In more severe cases, a doctor’s care or surgery may be necessary. Either way, there are options available to help you identify treatments and enjoy regular activities.
What: As many as 5.5 million women in North America have symptoms of endometriosis.
The Symptoms: Adominal cramping, pelvic and lower back pain, heavy periods, and increased infertility.
(Editor’s Note: Thomas Waliser, M.D., is a gynecological surgeon with Northwest Allied Physicians. His can be reached at 742-1565.)