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Endometriosis Explained

By: Silvia DiPaola, Contributing Writer

Endometriosis is a common uterine problem in women so you may hear this term being thrown around often. What exactly is it? Although endometriosis can cause infertility if left untreated, when addressed properly, it doesn’t hinder a person’s ability to live their life.

Endometriosis is a condition wherein the tissue that normally lines the uterus grows outside of it. This condition gets its name from the endometrium (the tissue that normally lines the uterus or womb). These irregular patches of tissue are called nodules or lesions. Growths attributed to endometriosis can swell and bleed in just the same way as the normal lining inside of your uterus every month during your menstrual period. If left untreated, the growths can continue to expand and cause problems, such as blocking the fallopian tubes, forming scar tissue that can cause pelvic pain and make it hard for you to become pregnant, and various other problems in your intestines and bladder. The lesions are most commonly found on or under the ovaries, fallopian tubes, behind the uterus, on the tissues that hold the uterus in place, on the bowels, and/or the bladder. Thus, women with endometriosis are more likely to have infertility or trouble getting pregnant. In fact, according to the Office of Women's Health, endometriosis is the cause of infertility in 24-50% of infertile women. In mild to moderate cases, it can be reversed through surgical removal of the nodules. However, there are severe cases that will result in permanent infertility, but these are very rare. Symptoms of endometriosis include painful menstrual cramps in the abdomen or lower back, pain during sexual intercourse, abnormal or heavy menstrual flow, painful urination or bowel movements during your period. Other gastrointestinal problems, such as diarrhea, constipation, and/or nausea are also common. However, symptoms will vary based on the individual. For example, some women who have severe endometriosis might experience no pain at all, while others with a milder form of the disease may have severe menstrual pain.

Scientists don't fully understand why endometriosis occurs in some individuals, but they believe heredity may be an important factor. There have been some risk factors discovered, but any woman who has received her menstrual period is susceptible to acquiring endometriosis. The average age of diagnosis is 27 years, although endometriosis can also occur among adolescents. You are at higher risk for acquiring endometriosis if you have a mother or sister with endometriosis, if your period started before age 11, your monthly cycles are relatively short (less than 27 days), or if your menstrual cycles are heavy and last more than 7 days total.

Diagnosis of endometriosis requires direct visualization, specifically through a pelvic laparoscopy (a minimally invasive surgical procedure). Laparoscopy procedures are used to determine the location, extent, and size of the lesions. An ultrasound, CT scan, or MRI scan may also be involved in a diagnosis. A gynecologist will diagnose a woman with endometriosis in 4 different stages: minimal, mild, moderate, and severe. This is based on the location, amount, depth, and size of the nodules.

Treating endometriosis is a bit tricky, as it may sometimes involve something known as “watchful waiting” to observe the course of the condition. Hormone therapy to reduce menstrual flow and pain medication to alleviate the symptoms might be used. Endometriosis can also be treated through minor surgical procedures that involve the removal of endometrial growths. In severe cases, a hysterectomy (removal of the uterus) might be needed. However, this is very rare.

Endometriosis may seem like a scary condition, but it can be treated. While there is no cure or prevention for endometriosis, you can reduce your risks of acquiring it by exercising regularly, avoiding excessive caffeine consumption, and avoiding large amounts of alcohol. If you have any of the symptoms aforementioned, you may want to consult your gynecologist. According to Hopkins Medicine, At least 11% of women, or more than 6 ½ million individuals, have this condition in the United States and live relatively normal lives. If you are diagnosed with endometriosis, know that you are not alone!

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