Endometriosis is a uterine condition affecting millions of women of all ages. Women with endometriosis experience a wide range of symptoms, and it’s crucial to understand this condition’s effects on a woman’s body.
Some women with endometriosis can manage the symptoms with simple treatments like hormone therapy or birth control, while others may require surgery. About 30 to 40 percent of women with endometriosis experience infertility because of the condition.
What Is Endometriosis?
The endometrium is the tissue that lines the walls of the uterus, and endometriosis is a condition that affects these tissues. A woman with endometriosis will start accumulating endometrium tissue outside the uterus, usually inside the abdominal cavity.
Unfortunately, the tissues outside the uterus still respond to the menstrual cycle the same as the tissues inside the uterus. Once a period begins, these tissues will break apart and bleed. While the endometrium tissues inside the uterus can exit through the cervix, the tissues outside the uterus have nowhere to go.
Symptoms and Severity
The endometrium tissues that dissolve and bleed in the abdominal cavity will aggravate the other tissues around the uterus and cause inflammation, swelling and severe cramping pains. Doctors refer to the tissues scarred by endometrium tissues as nodules, implants, growths or lesions.
Most commonly, endometriosis affects:
- Fallopian tubes
- Ligaments supporting the uterus
- The area between the uterus and the rectum
- The outside of the uterus
- The lining of the pelvic cavity
In rare cases, endometrium tissues can accumulate in the intestines, anus, bladder, cervix, vagina or vulva. In extremely rare cases, doctors have located endometrium tissues in patients’ thighs, arms and lungs.
Endometriosis is a progressive condition that may not manifest noticeable symptoms until many years after menstrual periods begin. Each cycle causes more endometrium accumulation. Over the years, the endometrium implants grow and affect more tissues. Menopause generally causes the symptoms of endometriosis to subside and the implants to deteriorate.
The early symptoms of endometriosis typically include more significant:
- Menstrual cramping
- Abdominal pain
- Lower back pain
- Pain or discomfort during sexual intercourse
Endometrium implants can cause irritation that can progress into infections, abscesses or areas of the body that are tender to the touch. If endometriosis affects the tissues of the intestines or bladder, it can cause urinary or intestinal pains as well.
Diagnosing Endometriosis Cases
Doctors categorize endometriosis cases based on:
- The amount of tissue accumulation
- The location of those tissues
- The severity of the patient’s symptoms
Small, isolated endometrium implants would be mild endometriosis, while more significant lesions would be moderate to severe endometriosis. More severe cases of endometriosis will also create more scar tissue.
A doctor will need to review a patient’s entire gynecological history to properly diagnose endometriosis. The doctor must also perform a full physical examination and a pelvic examination.
After those steps, a positive diagnosis is possible with a laparoscopic procedure. During this procedure, the doctor inserts a laparoscopic surgical instrument through a small abdominal incision to view the internal organs and locate endometrium implants.
Treatment Options for Endometriosis
Doctors suggest simple pain medications such as ibuprofen for mild cases of endometriosis. For other patients, hormone suppressants can be an effective solution with the added benefit of preventing pregnancy, if desired. Some women opt for temporary hormone suppression therapy, so they can attempt to conceive afterward.
Hormone treatment is very effective for small, isolated endometrium implants. Oral contraceptives that contain estrogen and progestin or synthetic progestin pills can provide relief in some cases.
Other women may require more robust treatments with synthetic pituitary blockers or gonadotropin-releasing hormone agonists. These medications block hormones from the pituitary gland that contribute to the menstrual cycle. While these monthly injections are effective for some women, they also cause bone mineral loss.
Some women with severe endometriosis will require surgery for relief. In these cases, surgeons will try to remove as much of the endometrium implants as possible without risking damage to the surrounding tissues.
Some surgeons opt for laparoscopic laser removal, which involves cauterizing or vaporizing sections of endometrium tissues with minimal invasiveness. Laparoscopic procedures also have shorter recovery times than typical abdominal surgeries.
For extremely advanced cases, more drastic surgical options may be the only solution. A hysterectomy or ovary removal may be required to stop the symptoms of endometriosis.
It’s vital for any woman considering any level of surgery to discuss the issue at length with her doctor. A surgical procedure of any type can lead to permanent hormone irregularities or infertility, so learn the risks beforehand.
Take Control of Your Uterine Health
Keeping close tabs on your menstrual cycles and uterine health are important at any age. Every endometriosis case is different, but any case is manageable with early detection, symptom management and careful screening. The providers who work with Arizona Gynecology Consultants can handle any aspect of gynecological care, so contact us today if you would like more information about endometriosis or treatment options.
Founder and Medical Director of ARIZONA GYNECOLOGY CONSULTANTS
Dr. Kelly Roy is a specialist in surgical gynecology and advanced laparoscopy (and hysteroscopy). She is a long-time resident of Arizona and obtained her Bachelor of Science degree in Biomedical Engineering at Arizona State University before finishing her Doctorate of Medicine at the University of Arizona in 1997.
Dr. Roy completed her residency in Obstetrics and Gynecology at the then “Banner Good Samaritan Hospital” (now Banner University Medical Center), in Phoenix Arizona in 2001.
Well known for her teaching and surgical ability, she is on the faculty at the residency program at both Banner University Medical Center and Saint Joseph’s Hospital in central Phoenix and is a Clinical Assistant Professor of Medicine at the University of Arizona College of Medicine, Phoenix Campus. Dr. Roy has taught advanced surgical techniques to medical students, residents, fellows and colleagues for over 15 years.
Dr. Roy is also a consultant to the medical device industry and has participated in the design and clinical testing of many instruments and surgical devices available on the world-wide market today.