Endometriosis

Endometriosis is a persistent condition in which tissue similar to the lining inside the uterus (the endometrium) grows outside the uterus, and can attach to places like the fallopian tubes, ovaries and other pelvic organs. It can also occur in other areas like the intestines, bladder and rectum.

Even though the tissue is outside the uterus, it thickens and sheds during the menstrual cycle, but it can’t leave the body like menstrual flow. This can cause inflammation, cysts and scar tissue throughout the pelvic region.

Endometriosis can cause pain — from minimal to severe — especially during menstrual periods. It may lead to fertility problems.

A fairly common chronic disorder, endometriosis affects more than 5 million U.S. women during their reproductive years (ages 15 – 49). Fortunately, effective treatments are available at El Camino Women’s Health.

Prevention

Researchers have yet to discover the cause of endometriosis, and there’s no known way prevent it. But it may help to know what increases your risk for the disease.

Studies show that endometriosis occurs more often in women who have:

• A first-degree relative (mother, sister, daughter) with the condition
• Given birth for the first time after age 30
• An abnormal uterus

Although more research needs to be done, studies also suggest that you may lower your chances of developing endometriosis, or at least manage its symptoms, if you:

• Exercise regularly
• Maintain a healthy weight
• Drink little or no alcohol and caffeine

Symptoms

Symptoms of endometriosis vary greatly. They range from no symptoms to disabling pain and infertility. With other diseases, the severity of pain usually reflects the severity of the disease. But endometriosis is different. A woman with a severe case of endometriosis may experience no symptoms, while a woman with only a mild case may experience severe pain.

The most common symptoms include:

• Difficulty getting pregnant – Affects about 40 percent of women with endometriosis
• Digestive problems – Diarrhea, constipation, bloating and nausea; usually most significant during your period
• Excessive bleeding – Heavy bleeding or bleeding between periods
• Pelvic pain – Unusually painful menstrual cramps, pain during or after sex, or pain during urination or bowel movements

Diagnosis

Diagnosis begins with a thorough pelvic exam where your doctor feels for signs of cysts and scars. If your El Camino Health doctor suspects endometriosis, you will likely undergo some imaging tests to show your doctor what is going on inside your body. These may include:

• Computed tomography (CT scan) – Uses a combination of X-rays and computer technology to produce cross-sectional images of bones and soft tissues
• Magnetic resonance imaging (MRI) – Uses a combination of a large magnet, radio waves and a computer to produce detailed images of bone and soft tissue
• Ultrasound exam – Uses high-frequency sound waves to produce images of internal structures to check for ovarian cysts from endometriosis

However, the best method for diagnosing endometriosis is through a biopsy. Your doctor can remove a small sample of tissue through minimally invasive surgery then examine the tissue beneath a microscope. A laparoscope — a thin tube with a lens and a light inserted through a small incision in the abdominal wall — allows your surgeon to view the inner pelvic area to find and remove suspicious tissue.

Treatment

Treatment for endometriosis is focused on helping you manage symptoms. Therapies range from no treatment, to medications, to a range of surgical methods to remove adhesions and cysts.

Nonsurgical Treatments

Common nonsurgical treatments include:

• Pain medications – Non-steroidal anti-inflammatory drugs may be enough to manage pain comfortably. These include ibuprofen (Advil) or naproxen (Aleve).
• Hormone therapy – Prescription hormones can help slow the growth of endometrial tissue and help relieve symptoms by preventing ovulation or reducing or stopping your menstrual flow.

Surgical Treatments

When nonsurgical treatments aren’t effective, your doctor may recommend surgery to relieve your symptoms. Options include:

• Laparoscopic surgery – Your surgeon makes small incisions in the abdomen and inserts a small camera (laparoscope) to examine the tissues and organs in the abdominal and pelvic cavity. Once found, the endometrial tissue is either destroyed with laser, electric current, or extreme heat or cold (ablation). Your surgeon may also remove the tissue by cutting it out (wide excision).
• Laparotomy – If the bowel or other organs are significantly affected by endometriosis, your surgeon may make one large incision in the abdomen to look inside and treat the condition.
• Hysterectomy – Generally used as a last resort for women experiencing extreme symptoms, this surgery removes the uterus. A total hysterectomy removes both uterus and ovaries.

El Camino Health Women's Health Services

With endometriosis, knowledge is power. Many women take painful menstruation cycles in stride. But for women with endometriosis, pain can start before their period and continue for days after the period has ended. Let your doctor know about any pain you have during your period as well as before and after.

At El Camino Health, our women-specific programs are designed to support you in the medical issues that are unique to you as a woman. We offer programs for breast health, gynecologic care and more. We’re committed to empowering you with the information and tools you need to take control of your health.