Endometriosis occurs when the tissue from inside the uterus is found outside the uterus. During a menstrual cycle, this tissue becomes activated and will irritate organs that it is touching or near causing pain, swelling, inflammation, and scarring. The endometrial implants can be on the ovary (causing ovarian pain and an abnormal appearing ovary). It can be on the bladder or bowel causing difficulty or pain with bowel movements or urination. It can be on the fallopian tubes causing scar tissue resulting in infertility and ectopic pregnancy. The endometrial tissue can be deep in the pelvis and cause pain with intercourse. Endometriosis is activated by estrogen, a female hormone naturally produced in the body. Individuals who are at an unhealthy weight produce even more estrogen that can activate endometrial tissue. Endometriosis occurs in 1 out of 10 women and commonly between the ages of 30 and 40 years old.
Endometriosis can only be diagnosed by performing a surgery (i.e. laparoscopy) to visualize endometrial tissue and adhesions. Endometriosis can be suspected based on a patient’s history and physical exam. Endometriosis can’t be cured, but it can be managed with medication, surgery or both. The first line of medical management is NSAIDs (ibuprofen, Aleve, Advil), contraception, and gonadotropin-releasing hormone agonists. Medical treatment helps to manage a patient’s symptoms by preventing ovulation and minimizing inflammation and adhesions. Recurrence rates are high after discontinuation of medication. A surgical procedure (ie Laparoscopy) can removal visible endometrial tissue and adhesions. This will relieve pain and improve fertility rates.
If you are having symptoms, and you are concerned about endometriosis, then make an appointment with your Gynecologist for education and recommendations. Endometriosis is a chronic condition that can be managed affectively, but treatment can take multiple approaches, and requires patience and open communication with your provider.
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