Endometriosis Evaluation & Treatment

Understanding Endometriosis

Endometriosis occurs when the tissue that normally lines the inside of the uterus migrates to and grows in other areas of the body. Usually the endometrial tissue spreads to the ovaries, bowel, and most commonly, the peritoneum which lines the abdominal cavity.

When endometrial tissue grows in its proper place – inside the uterus – it goes through the same cycle every month: first it thickens along the uterine wall, then it breaks itself down and finally, it bleeds out of the body via the vagina as part of a normal menstrual period.

When the endometrial tissue grows outside of its proper place – or, in other words, when endometriosis occurs – the misplaced tissue still acts in the same manner as it normally would and responds to hormonal changes in a way that is similar to the cells found inside the uterus. Endometrial tissue may “bleed” at the time of menstruation. However, the blood accumulates locally, causing swelling and inflammatory responses. This tissue can later develop into scar tissue, or it can begin to attach various organs to each other.

Your symptoms may include:

  • Pelvic pain
  • Periods that are more painful than normal
  • Cramps – of any level of severity – that can start a week or two before your period and last for a week or two after
  • Infertility
  • Pain during sex
  • Painful urination and bowel movements
  • Bleeding between periods

However, some women with endometriosis experience no symptoms.

Complications
Fertility problems are the most common complications stemming from endometriosis. Women with more severe forms of the condition usually experience more fertility problems than those with milder forms. Likewise, the longer you’ve had endometriosis, the tougher it becomes to conceive.

Treatment Options
Our goals in treating your endometriosis are to decrease menstrual bleeding, to thin the endometrial tissue and to reduce the associated pain that you experience. In order to accomplish this, we will counsel you regarding your treatment options. Our recommendations may include medications for pain management; hormonal therapies including the use of oral contraceptives, DepoProvera, DepoLupron or the Mirena IUD; or surgical intervention.

Fortunately, most symptoms of endometriosis subside once a woman has gone through menopause because her estrogen level declines.