Understanding Endometriosis

If you have painful periods, irregular bleeding, pelvic pain, or have even had trouble getting pregnant, you could be among the 9 percent of American women with endometriosis.  While this common condition can be disabling, there are plenty of treatment options that can cure it or make living with endometriosis a whole lot easier. 

What is endometriosis? 

The endometrium is made of cells that line the uterus. During the course of a menstrual cycle, they grow and thicken. If you don't get pregnant, they're shed when you have a period.

According to the National Endometriosis Foundation: In women who have endometriosis, menstrual fluids leak back into the body in areas outside of the uterus. These fluids have no way to exit and eventually accumulate on the bladder, bowel, top of the vagina or other nearby organs, leading to the development of scarring and fibroid-like nodules. This causes symptoms that vary from severe cramping to chronic pelvic pain, severe painful periods, infertility, painful sex, painful bowel movements and rectal pain.

What are the symptoms of endometriosis?

  • Pelvic pain
  • Painful periods
  • Painful intercourse
  • Irregular vaginal or uterine bleeding
  • Irregular vaginal clotting
  • Infertility
  • Irregular bowel movements (diarrhea or constipation)
  • Rectal bleeding during menstruation
  • Painful bowel movements
  • Sharp rectal pain
  • Increased gas and bloating
  • Nausea
  • Unexplained iron-deficiency

Many women are misdiagnosed for years with conditions like irritable bowel syndrome, dysmenorrhea (painful cramps), pelvic inflammatory disease or even appendicitis before being correctly diagnosed with endometriosis. That may mean years of unnecessary pain and ineffective pain management.  It may also  lead to serious complications.   Endometriosis can cause scarring and is among the top three causes of infertility. The earlier it is diagnosed the better. 

Who's at risk?

The American Congress of Obstetricians and Gynecologists (ACOG) say endometriosis is most common in women in their 30s and 40s, but can occur any time in women who menstruate. It occurs more often in women who've never had children. Women with a mother, sister, or daughter who've had endometriosis are more likely to have it. Endometriosis is found in about three quarters of women with chronic pelvic pain.

How is endometriosis diagnosed?

Gynecologists do a pelvic exam and usually a minor surgical procedure called laparoscopy to look directly at and biopsy uterine tissue.  This is usually a day surgery procedure and most women recover fully within days. 

How is endometriosis treated?

ACOG says treatment depends on the extent of disease, symptoms, and whether a woman wants to have children. Treatment may include medication, surgery, or both. Although treatments may relieve pain and infertility for a while, symptoms may eventually come back.

Common medications used to treat endometriosis include pain medications like nonsteroidal anti-inflammatories (ibuprofen) and sometimes narcotics.  Hormones including oral contraceptives may slow down growth of endometrial tissue.

When medications aren't enough, surgery to remove endometrial and scar tissue is usually effective.  If pain is very severe, the patient doesn't want to have children and less invasive surgery doesn't work, some women choose to have a hysterectomy (removal of the uterus and surrounding scar tissue). 

Endometriosis can be a frustrating long-term condition.  If you have symptoms of endometriosis, talk to your doctor about treatment options.



American Congress of Obstetricians and Gynecologists

Patient Pamphlet - Endometriosis



Endometriosis Foundation of America