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Categories > Pelvic Pain and Disorders > Endometriosis

Managing endometriosis

Endometriosis is one of women’s most common health problems, affecting about 5 million American females, according to the U.S. Department of Health and Human Services. The condition can cause severe pain, irregular bleeding, infertility or other symptoms.

Misplaced tissue

During a woman’s menstrual cycle, hormones cause the uterus’ lining, called the endometrium, to thicken and grow as it prepares for possible pregnancy. If no pregnancy occurs, the lining breaks down and leaves the body as menstrual blood. In endometriosis, tissue from this lining transplants itself outside the uterus. Misplaced endometrial tissue that grows where it shouldn’t—on ovaries, behind the uterus or on the bowel or bladder—thickens, grows and breaks down each month, too. But that blood can’t exit the body, causing inflammation, cysts, scar tissue, adhesions and larger growths.

Suffering the symptoms

Pain and infertility are the most common symptoms of endometriosis. How much pain a woman feels, however, isn’t related to the extent of her disease. Some women who have only a few patches of endometriosis suffer debilitating pain, while others with far larger growths feel little discomfort. Other women don’t feel any symptoms and may not know they have the disease until they have trouble becoming pregnant. Because endometriosis—and its effect on fertility—usually worsens with time, doctors often urge women who have the disease not to delay having children. Infertility affects 30 percent to 40 percent of women with endometriosis.

Other symptoms include:

  • painful periods that worsen over time
  • chronic lower back or pelvic pain
  • pain during or after sex
  • painful bowel movements or urination during periods
  • heavy or prolonged menstrual periods
  • spotting or bleeding between periods
  • fatigue
  • gastrointestinal problems like diarrhea, constipation and bloating

The only way to diagnose endometriosis is through laparoscopy, a minimally invasive procedure in which a thin viewing tube is passed through a tiny incision in the abdomen so your doctor can see the abnormal growths.

Seeking treatment

There’s no cure for endometriosis, but your healthcare provider can offer several treatment options to help relieve pain and other symptoms and improve fertility. They include:

  • Pain medication. Over-the-counter pain relievers like ibuprofen (Advil or Motrin) or naproxen (Aleve) may relieve mild pain. If your pain is severe, your provider can prescribe a stronger drug.
  • Hormone therapy. Oral contraceptives block the monthly hormones’ effect on endometrial tissues and help make periods lighter and less uncomfortable. Gonadotropin-releasing hormone (GnRH) agonists are used for short-term treatment (no longer than six months). They shut down estrogen production, leading to an induced temporary menopause with symptoms like hot flashes, vaginal dryness and bone loss. Some women can tolerate these symptoms longer if they also take estrogen.
  • Surgery. Your doctor may remove or destroy the growths with laparoscopy. Extensive disease may require traditional abdominal surgery or laparotomy.