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Endometriosis

Overview

Endometriosis is a disorder that causes irregular tissue growth in the reproductive organs and pelvis. Endometrial tissue can grow into the ovaries, bowels, and other areas of the pelvis, leading to pain and problems with fertility. In normal circumstances, endometrial tissue thickens over the course of a woman’s menstrual cycle, eventually breaking down and bleeding. This same process occurs when a woman is suffering from endometriosis, but the broken down tissue has no place to go. Trapped in other parts of the body, it causes pain and develops into adhesions and scar tissue. In many cases, this abnormal tissue binds together separate organs.

Symptoms of Endometriosis

There are several symptoms associated with endometriosis, the most prevalent of which is painful periods. Women suffering from endometriosis describe pain and cramping that extends for several days that can be debilitating during their menstrual periods.

Women with endometriosis might also experience pain during and after intercourse, and pain with bowel movements or urination. Other symptoms include heavy bleeding during the menstrual period, bleeding between periods, difficult getting pregnant, fatigue, constipation, diarrhea, bloating, and nausea. Many of these symptoms are especially bad during the menstrual period.

Symptoms can vary from woman to woman, as can the severity of the pain. You should speak with your doctor if you are experiencing severe or chronic pain in the pelvis, or any of the symptoms listed above. Endometriosis is sometimes misdiagnosed as ovarian cysts or pelvic inflammatory disease, but in all cases, the earlier the cause of the pain is discovered, the easier the problem is to fix.

Causes of Endometriosis

Most researchers agree that the primary cause for endometriosis is retrograde menstruation. This occurs when menstrual blood flows back through the fallopian tubes and into the pelvic cavity. This blood contains endometrial cells, which attach to surfaces of the pelvic walls and organs. They grow and thicken, eventually bleeding as they would during a normal menstrual cycle. Another possible cause is the abdominal lining turning into endometrial cells.

Who Is At Risk For Endometriosis?

There is no way to determine exactly who will develop endometriosis, but there are some risk factors that increase a woman’s chances. These include:

  • Family history of endometriosis
  • Short menstrual cycles with longer periods of bleeding
  • Medical conditions that impede the menstrual flow
  • Never giving birth
  • History of pelvic infections


Most women develop endometriosis several years following the start of menstruation. Women who become pregnant see a decrease in symptoms and all women experience relief from the condition once menopause begins.

In addition to causing pain, endometriosis also impairs fertility. Up to one half of women suffering from endometriosis have a difficult time getting pregnant. It is possible for women with mild to moderate endometriosis to conceive, but women are encouraged to get pregnant as soon as possible. Years of endometriosis decrease a woman’s chances of getting pregnant even further.

How Is Endometriosis Diagnosed?

There are three tests a doctor can conduct if endometriosis is suspected, but only one provides an absolute diagnosis of endometriosis. If you and your doctor believe endometriosis might be a problem, he or she will conduct a pelvic exam to feel for abnormalities. If this is inconclusive, an ultrasound will be ordered. During this process, the reproductive organs are scanned and video imaging is used to view endometriosis or other problems. At this point, your doctor might prescribe a treatment plan, even though the diagnosis is not officially conclusive.

When these treatments are unsuccessful, laparoscopy will be ordered. This process allows the doctor to look into the abdomen for signs of endometrial tissue. Endometriosis is often treated during the laparoscopy, with the removal of the tissue buildup.

How Is Endometriosis Treated?

There are several treatments available for endometriosis. Your doctor will determine your treatment plan based on the severity of your endometriosis. Pain medication is one of the most popular methods for controlling the pain and cramping associated with the condition. Sometimes, pain medication is enough to make life with endometriosis bearable.

Hormone therapy might also be prescribed. Hormone therapy includes hormonal contraceptives, such as birth control pills, gonadotropin-releasing hormone agonists and antagonists, Danazol, Depo-Provera, and aromatase inhibitors.

If hormone therapy is not enough to alleviate the symptoms of endometriosis, you and your doctor will need to consider surgery. Conservative surgery options remove the endometrial tissue from the pelvis to alleviate the pain. The tissue can re-grow, so this is not a permanent solution. If your problem is severe, a hysterectomy might be necessary. Since this is drastic surgery, eliminates a woman’s ability to have children, and causes a variety of side effects if performed before natural menopause begins, it is considered the last resort for endometriosis treatment.

If you believe endometriosis is causing your pain, speak with your doctor at Women’s Health Care of Georgia.




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