The cause of endometriosis is uncertain. It occurs when cells lining the uterus grow into other areas of the body. Normally, if a woman doesn’t get pregnant, this tissue is shed each month during her period. In endometriosis, tissue that looks and acts like endometrial tissue implants outside the uterus. Each month, this misplaced tissue responds to the hormonal changes of the menstrual cycle. It builds up, breaks down, and bleeds. But, the blood has nowhere to go. This causes surrounding tissue to become inflamed or swollen. It can also cause scar tissue, chronic pain, and heavy periods.
Who is at risk for endometriosis?
The condition affects one in 10 women of reproductive age, according to the American College of Obstetricians and Gynecologists. Any woman may develop endometriosis, but increased risk is seen for:
- Women who have a mother, sister, or daughter with the disease
- Women who gave birth for the first time after age 30
- White women
- Women with an abnormal uterus
Can endometriosis make it hard for me to get pregnant?
Endometriosis is a main cause of infertility in women. This can happen if the tissue implants in the ovaries or fallopian tubes. Tissue can also implant on other organs in the pelvis.
What are the causes of endometriosis?
Endometriosis can cause chronic pelvic pain during menstrual cycles or sexual intercourse; heavy or irregular menstrual bleeding; sleep problems; and constipation, diarrhea and digestive issues. The amount of pain isn’t always related to the severity of the disease.
How is endometriosis diagnosed?
We’ll review your health history and do a physical and pelvic exam. We also may do tests such as an ultrasound, CT scan or MRI. We will need to do a laparoscopy to confirm you have endometriosis. The laparoscopy shows us the location and extent of endometriosis. This is an outpatient procedure where you will be sedated and go home the same day.
How is endometriosis treated?
Endometriosis is usually treated with medications and/or surgery. The best treatment plan is determined by the location and severity of the symptoms, findings on pelvic exam and plans for future pregnancy.
Typical non-surgical treatment options include:
- Over-the-counter pain relievers (Advil, Motrin IB, etc.)
- Hormone therapy such as birth control pills or progestin alone
- Intermittent medical menopause using hormone suppression
Surgical options are typically conservative, using minimally invasive laparoscopic surgery to remove the burden of endometriosis and scar tissue without removing the reproductive organs. For women where conservative surgery hasn’t worked well and they have completed their childbearing, total laparoscopic hysterectomy with or without removal of the fallopian tubes and ovaries provides the greatest promise for symptom relief.