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OVERVIEW

What is endometriosis?

Endometriosis is a medical condition in which tissue that is similar to that in which lines the uterus grows elsewhere in the body.   It can grow on your ovaries, in your pelvis, on your bladder, or in other areas.

SYMPTOMS

What are the symptoms of endometriosis?

Endometriosis symptoms are similar to those of other health problems: 

• Heavy menstrual bleeding.
• Severe cramping or pain before and/or during your period.
• Frequent spotting or bleeding between periods.
• Pain while going to the bathroom during your period.
• Pain with sex
• Pain in your stomach, low back, or rectum.
• Problems with fertility.
• Unexplained exhaustion or lack of energy
• Digestive or gastrointestinal issues or symptoms.

The location and size of patches do not relate to the amount of pain you may have.

CAUSES

What causes endometriosis?

Healthcare providers and researchers do not know the cause of endometriosis. Genetics plays a part. It can run in your family. Retrograde (backwards) menstrual flow is another possible cause. This is when some of the tissue that is shed during your period flows up instead of out. It ends up in your fallopian tubes and other parts of your pelvis.

Other factors include your body’s response to estrogen and progesterone. If your body resists progesterone, it can have a hard time shedding the uterine lining. Some people have flawed immune systems. This means their bodies don’t destroy all of the lining. The leftover lining then attaches to the outside of your uterus.

DIAGNOSIS & TESTS

How does my healthcare provider know I have it?

Your healthcare provider may do a physical and pelvic exam.  They may also review your symptoms, health history, and family history.

 Laparoscopic surgery can confirm the diagnosis. This common procedure allows the healthcare provider look inside your uterus. Your healthcare provider will make a small cut in your abdomen.  They will use a small, lighted camera to look for patches of endometriosis. Your healthcare provider may take a sample of tissue to the lab.

PREVENTION

Can endometriosis be prevented or avoided?

You cannot prevent or avoid endometriosis. Some women have an increased risk for the condition. Factors that increase your risk include:

• Family history.
• Starting menstruation early (before the age of 11).
• Short menstrual cycles (27 days or less).
• Long, heavy periods (7 days or more).
• Starting menstruation late.
• Low body fat.
• Regular exercise (4 or more hours each week).
• Pregnancy

TREATMENT

Endometriosis treatment

Several types of medicine can treat endometriosis, including:

• Over-the-counter medicine can relieve pain and inflammatory.
• Birth control pills can regulate your hormones and reduce heavy bleeding.
• The hormone, progestin, can manage symptoms over time. It comes in the form of a shot or a pill.
• Danazol and GnRH analog are hormone shots that stop your periods. This gives your uterus a break from a buildup of tissue. Unfortunately, these shots have side effects similar to menopause. These include hot flashes, vaginal dryness, and unwanted facial hair. Taking a daily estrogen pill can reduce these side effects.
• Aromatase inhibitors, such as exemestane and letrozole, are a newer type of hormonal treatment.

Birth control pills, danazol, and GnRH analogs are taken for 6 to 9 months. During that time, your pain should get better. However, it may come back if you stop taking the medicine.

Your healthcare provider may recommend a procedure. It could be surgery or a diagnostic laparoscopy. In this procedure, the healthcare provider removes the endometrial tissue that has grown outside of your uterus. As a last resort, your healthcare provider may recommend a hysterectomy. This is would be the surgical removal of your uterus, and sometimes ovaries.

What happens during and after menopause?

For many women, endometriosis goes away at menopause, when periods stop. Until menopause, medicine and surgery may be able to help with symptoms of endometriosis.

LIVING WITH ENDOMETRIOSIS

Endometriosis can make it harder to get pregnant. You may need surgery and/or fertility treatments to help. Talk to your healthcare provider if you plan to become pregnant. Your healthcare provider may advise you to not put it off. The condition can get worse with age, so your chances of getting pregnant lessen over time. Usually, symptoms go away while you’re pregnant. Do not take prescription medicine when you’re trying to get pregnant.

Some studies have suggested that endometriosis may put you at a higher risk of getting ovarian cancer. However, the overall risk is low. Endometriosis often goes away or becomes milder with menopause. Until menopause, medicine and/or surgery may be able to help with symptoms.

FOR MORE INFORMATION

Endometriosis Information via The Society of Obstetrics and Gynaecologists of Canada
http://endometriosisinfo.ca/index_e.aspx