Endometriosis

Endometriosis occurs when there is endometrial tissue outside of the endometrial cavity. The endometrium lines a woman's uterus. Although this tissue can be found anywhere, it is commonly found in the pelvic area.

What happens to my body if I have endometriosis?

The endometrial tissue that has attached to other areas of the body responds to hormonal changes during your menstrual cycle as would the endometrial tissue lining your uterus. During menstruation this tissue will bleed as well. This leads to pain and inflammation and may cause scarring and adhesions as well.

What causes endometriosis?

The exact cause of endometriosis is unknown, however, there are a few theories on the cause of endometriosis. One theory is that the endometrial tissue results from remnants of embryotic tissue. Another possible theory is retrograde menstrual flow. With this theory, it is believed that during menstruation, menstrual flow backs up into the fallopian tubes.

Am I at risk for endometriosis?

Risk factors for endometriosis include:

  • early age of onset of first menstrual cycle
  • menstruation lasting 7 days
  • heavier than normal flow
  • menstrual pain
  • history of sister or mother with endometriosis

What are symptoms of endometriosis and how will my doctor know if I have it?

Symptoms of endometriosis include:

  • pelvic pain
  • painful menstruation
  • painful intercourse
  • abnormal uterine bleeding
  • painful defecation
  • excessive or prolonged menstruation
  • bleeding or spotting between menstrual cycles
  • infertility

Your doctor will normally do a pelvic exam and check for fixed tender areas. She may also do a pelvic ultrasound or run blood tests to rule out other possible cause of your symptoms. A laparoscopy is the most definitive way to diagnose endometriosis.

What are treatment options for endometriosis?

Your doctor may recommend analgesics such as tylenol and/or NSAIDS (nonsteroidal antiinflammatory drugs). Another common treatment used is oral contraceptives. Since oral contraceptivers can shorten menstruation or stop it all together this may help relieve symptoms. They also help in regulating the growth of endometrial tissue. Other hormonal medications, including male hormone derivatives may be used, however, side effects include decreased breast size, voice changes, and other masculine attributes.

Surgical options include laser ablation of endometrial tissue and hysterectomy.

Menopause will alleviate symptoms and endometriosis may also regress during pregnancy due to lack of menstrual cycles during that time.

How does endometriosis effect my fertility?

Because endometriosis can cause scarring and adhesions this can unfortunately lead to difficulty conceiving and/or infertility. Women who have endometriosis are encouraged to have children early.

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