What is Endometriosis? Endometriosis Treatment and Causes
Endometriosis is a chronic gynecological condition that can cause chronic pelvic pain and infertility in reproductive-aged women. It occurs in about one-tenth of women in this age group with increased prevalence in patients experiencing chronic pelvic pain or infertility. Dr. Ryan Brosch from Women’s Care breaks down endometriosis treatment, diagnosis, and possible causes.
What causes endometriosis?
There are several theories on why endometriosis occurs. The most commonly accepted theory is that endometriosis can occur during menses when endometrial tissue flows through the fallopian tubes instead of out of the cervix, where it attaches to organs of the pelvis, such as the fallopian tubes, ovaries, uterus, and colon. This causes inflammation that can result in the formation of adhesions or scar tissue inside the pelvis, which can cause chronic pain and potentially infertility.
Common symptoms and diagnosis
Endometriosis can be asymptomatic in women, only discovered during surgery performed for other reasons. In some women, however, endometriosis can cause chronic pelvic pain, extremely painful periods, pain with intercourse, and even pain with urination or bowel movements.
Endometriosis is only definitively diagnosed through surgery. Your gynecologist may offer you surgical treatment with laparoscopy, where a camera is used to visualize the inside of the abdomen. The camera allows surgeons to operate through small incisions with long instruments. Areas that are concerning for endometriosis may be biopsied or removed for assessment under a microscope to confirm the diagnosis. Before surgery, a gynecologist will likely perform a pelvic exam and may offer a pelvic ultrasound to assess for other issues that may be causing pain.
The primary treatment for endometriosis involves hormonal suppression of ovulation with birth control pills, progesterone-only medications such as Provera, as well as other medications that can decrease the release of hormones from the ovaries, such as gonadotropin-releasing hormone agonists like Lupron.
These medications may be offered before confirming the diagnosis with surgery. Pain is best controlled with non-steroidal anti-inflammatories, such as ibuprofen. If symptoms persist despite medication use, or if an original evaluation via ultrasound shows abnormal findings, such as large cysts, a gynecologist may offer surgery to both confirm the diagnosis and to attempt to remove endometriosis and associated scar tissue to improve symptoms and decrease pain.
Endometriosis and infertility
Women with endometriosis have increased risk of infertility due to inflammation caused by endometrial implants that can damage sperm or egg, or interfere with their movement through the fallopian tube and uterus. The fallopian tube can end up being blocked from adhesions caused by the endometriosis. Women with chronic pelvic pain and infertility may be candidates for surgery for diagnosis and treatment of endometriosis.
If you feel you might be showing symptoms of endometriosis or would like to know more about endometriosis treatment, schedule an appointment with Women’s Care today.