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Conditions

Endometriosis

Endometriosis may affect more than 11% of American women between 15 and 44.1 It is especially common among women in their 30s and 40s. Some women with endometriosis have issues getting pregnant. Several different treatment options can help manage the symptoms and improve your chances of getting pregnant.
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Definition

Endometriosis happens when tissue similar to the lining of the uterus grows outside of the uterus. This tissue acts like regular uterine tissue does during your period: It will break apart and bleed at the end of the cycle. But this blood has nowhere to go. When this tissue grows in the wrong places, it can cause you to experience uncomfortable symptoms that can impact your daily life. Surrounding areas may become inflamed or swollen. You might have scar tissue and lesions.

Types of Endometriosis

There are three main types of endometriosis, based on where it is:

Superficial peritoneal lesion
This is the most common kind. You have lesions on your peritoneum, a thin film that lines your pelvic cavity.

Endometrioma (ovarian lesion)
These dark, fluid-filled cysts, also called chocolate cysts, form deep in your ovaries. They don’t respond well to treatment and can damage healthy tissue.

Deeply infiltrating endometriosis
This type grows under your peritoneum and can involve organs near your uterus, such as your bowels or bladder. About 1% to 5% of women with endometriosis have it.

Symptoms

The primary symptom of endometriosis is pelvic pain, often associated with menstrual periods. Although many experience cramping during their menstrual periods, those with endometriosis typically describe menstrual pain that’s far worse than usual. Pain also may increase over time.

Common signs and symptoms of endometriosis include:

  • Painful menstrual cramps that may go into the abdomen (stomach) or lower back
  • Pain during or after sex
  • Diarrhea or constipation during a menstrual period
  • Fatigue or low energy
  • Heavy or irregular periods
  • Pain with urination or bowel movements during a menstrual period
  • Spotting or bleeding between menstrual periods

The severity of your pain may not be a reliable indicator of the extent of your condition. You could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no pain.

Endometriosis
Treatments

There’s no cure for endometriosis. Treatments usually include surgery or medication. You might need to try different treatments to find what helps you feel better. Medications are often used to help control the symptoms of endometriosis. These can include pain medications and hormone therapies.
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Pain Medicine

Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can be effective for managing endometriosis pain. A doctor can also discuss whether you need prescription medications for more severe pain.
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Hormonal options for suppressing endometriosis can include:

Birth control: There are multiple forms of hormonal suppression options including combination options using estrogen and progesterone or progesterone-only options.

Gonadotropin-releasing hormone (GnRH) medications: This medication is actually used to stop the hormones that cause your menstrual cycle. This basically puts your reproductive system on hold as a way to relieve your pain.

Danazol (Danocrine®): This is another form of hormonal medication that stops the production of the hormones that cause you to have a period. While taking this medication for endometriosis symptoms, you may have the occasional menstrual period, or they might stop entirely.

With all of these medications, it’s important to note that your symptoms can come back if you stop taking the medication.

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Laparoscopic Surgery

Surgery is usually chosen for severe symptoms, when hormones are not providing relief or if you are having fertility problems. During the operation, the surgeon can locate any areas of endometriosis and may remove the endometriosis patches. After surgery, hormone treatment is often restarted unless you are trying to get pregnant.

Additional Resources

Learn more from the American College of Obstetricians and Gynecologists
Endometriosis