When I say, “endometriosis,” what comes to mind? For many, they draw a blank. For the 178 million women worldwide living with endometriosis, however, they know all too well. Since March is National Endometriosis Awareness Month, let’s increase our knowledge of this common women’s health issue.
What is endometriosis? Endometriosis occurs when cells from the lining of the uterus are found outside of the uterus. Just as the cells in the uterus are sensitive to hormones of the female reproductive cycle (estrogen and progesterone), so too are the cells outside of the uterus. Just before and during a woman’s period, those cells swell and begin to bleed just like their uterine counterparts. This irritates the surrounding tissue and causes pain.
What are the symptoms of endometriosis? Endometriosis is the leading cause of pelvic pain in women. Typically, the pain associated with endometriosis is worst just before and during a woman’s period; this is called dysmenorrhea. Depending on where the endometriosis is found, pain can also occur while urinating, having a bowel movement as well as with sex. There is a wide range of severity of symptoms. Some women will have disabling symptoms while others will have only mild symptoms.
How common is endometriosis? An estimated 1 in 10 women of reproductive age have endometriosis. You likely know someone who is affected by it.
Is endometriosis inherited like brown eyes or red hair? We think there is a genetic link to endometriosis, but is probably more complicated than that. Nevertheless, women whose sisters or mothers have endometriosis are approximately 7 times more likely to have it themselves.
I heard that endometriosis is associated with infertility. Is that true? Approximately 40 percent of women who are evaluated for infertility have endometriosis, but just because you have endometriosis does not mean you are infertile. If you are having difficulty becoming pregnant, you should consult your OBGYN.
How is endometriosis diagnosed? By taking a thorough history and performing a pelvic exam, your doctor can usually diagnose endometriosis. Sometimes, however, it is necessary to perform a laparoscopic surgery in order to see if there is endometriosis. The benefit of this is that endometriosis may be treated as well during the surgery.
What medical treatments are available for endometriosis? There are many effective medicines that can help with endometriosis, including NSAIDs such as ibuprofen, birth control pills, progestin-only injections, GnRH agonist injections and levonorgestrol IUDs.
When is surgery recommended? If you have tried some of the medications mentioned and did not have a response or the diagnosis is uncertain, a surgery may be suggested. You will make this decision with your OBGYN.
If you or someone you know has endometriosis, you are not alone. Talk with your primary care doctor or OBGYN about your symptoms and possible treatment.
Resources: ACOG.org, Endometriosis.org
Anne Dougherty, MD, is an obstetrician and gynecologist at the University of Vermont Medical Center. She is also an assistant professor at the Larner College of Medicine at UVM.