Facts About Endometriosis
What is endometriosis?
Endometriosis is a common, yet poorly understood disease that can strike women of any socioeconomic class or race. The name endometriosis comes from the word “endometrium,” which is the tissue that lines the inside of the uterus. Normally, if a woman is not pregnant, this tissue builds up and is shed each month as menstrual flow (your period). Endometriosis occurs when this tissue grows outside the uterus on the surfaces of organs in the pelvic and abdominal areas where it does not normally grow. Tissues surrounding the area of endometriosis may become inflamed or swollen, leading to the development of scar tissue. After menopause, the abnormal implants shrink away and the symptoms subside.
In what places, outside of the uterus, do areas of endometriosis grow?
Most endometriosis is found in the pelvic cavity, including:
- on or under the ovaries
- behind the uterus
- on the tissues that hold the uterus in place
- on the bowels or bladder
In extremely rare cases, endometriosis areas can grow in the lungs or other parts of the body.
What are some symptoms of endometriosis?
Endometriosis can affect a menstruating woman, from the time of her first period to menopause. One of the most common symptoms of endometriosis is pain, mostly in the abdomen, lower back and pelvic areas. The severity of pain a woman feels is not linked to the amount of endometriosis. Some women experience no pain even though their endometriosis is extensive, which means that the affected areas are large or there is scarring. Some women, on the other hand, have severe pain even though they have only a few small areas of endometriosis. The following are some symptoms of endometriosis:
- extremely painful (or disabling) menstrual cramps
- lower back, intestinal and pelvic pain
- pain during or after sex
- intestinal pain
- painful bowel movements or painful urination during menstrual periods
- heavy menstrual periods, or spotting or bleeding between periods
- infertility
What can raise my chances of getting endometriosis?
You are more likely to develop endometriosis if you:
- began getting your period at an early age
- have heavy periods
- have periods that last more than seven days
- have a short monthly cycle (27 days or less)
- have a close relative (mother, aunt, sister) with endometriosis
How can I reduce my chances of getting endometriosis?
Some studies suggest that you may lower your chances of developing endometriosis if you exercise regularly and avoid alcohol and caffeine.
Does endometriosis make you infertile?
Severe endometriosis with extensive scarring and organ damage may affect fertility. It is considered one of the three major causes of female infertility; about 30 percent to 40 percent of women with endometriosis are infertile. While the pregnancy rates for patients with endometriosis remain lower than those of the general population, most patients with endometriosis do not experience fertility problems. For those with endometriosis-related infertility, it is often treated successfully with hormones and surgery.
How do I know if I have endometriosis?
Currently, health care providers use a number of tests for endometriosis. The two most common are imaging tests - ultrasound, a machine that uses sound waves to produce images of organs and systems within the body and magnetic resonance imaging (MRI), a machine that uses magnets and radio waves to provide an image. The only way to know for sure is by having surgery. The most common type is laparoscopy. The surgeon uses a small viewing instrument with a light, called a laparsocope, to look at the reproductive organs, intestines and other surfaces to see if there is any endometriosis. The diagnosis can be confirmed by doing a biopsy, which involves taking a small tissue sample and studying it under a microscope.
What are the treatments for endometriosis?
There is no cure for endometriosis, but there are treatments. For patients who wish to become pregnant, doctors are advising that, depending on the age of the patient and the amount of pain associated with the disease, the best course of action is to have a trial period of unprotected intercourse for six months to one year. If pregnancy does not occur within that time, then further treatment may be needed. For patients not seeking to become pregnant the treatment may include:
- Pain medication — works well if the pain or other symptoms are mild. These medications range from over-the-counter remedies to strong prescription drugs.
- Hormone therapy — effective if your areas are small and/or you have minimal pain. Hormones can come in pill form, by shot or injection, or in a nasal spray. Common hormones used to treat endometriosis pain are progesterone, birth control pills, danocrine and gonadatropin-releasing hormone (GnRH).
- Surgical treatment — usually the best choice if your endometriosis is extensive, or if you have more severe pain. Surgical treatments range from minor to major surgical procedures. You and your health care provider should talk about possible options for removing endometriosis before your surgery. Then, based on the findings and treatment at surgery, you and your health care provider can discuss medical treatment options for after surgery.
More information about endometriosis can be obtained by contacting:
Endometriosis: Condition Information
National Institute of Child Health and Human Development
800-370-2943
The National Women’s Health Information Center, U.S. Department of Health and Human Services
800-994-9662