Endometriosis

Endometriosis is a common health problem in women in which the endometrium, or lining of the uterus, starts to grow outside the uterus. It can grow on other structures in the body, including the ovaries, fallopian tubes and pelvic cavity.

Symptoms of endometriosis may include:

• Pain in the lower abdomen or pelvis, or the lower back, mainly during menstrual periods

• Very painful menstrual cramps; pain may get worse over time

• Chronic pain in the lower back and pelvis

• Pain during or after sex

• Intestinal pain

• Painful bowel movements or painful urination during menstrual periods

• Spotting or bleeding between menstrual periods

• Infertility or not being able to get pregnant

• Fatigue

• Diarrhea, constipation, bloating, or nausea, especially during menstrual periods

Who is at risk of developing endometriosis?

More than five million women in the United States have endometriosis. It is one of the most common health problems for women. It can occur in any teen or woman who has a menstrual period, but it is most common in women in their 30s and 40s.

The symptoms of endometriosis stop for a time during pregnancy. Symptoms also tend to decrease with menopause, when menstrual periods end for good. In some cases, women who take menopausal hormone therapy may still have symptoms of endometriosis.

Recent research shows a link between endometriosis and a family history of:

• Allergies, asthma, and chemical sensitivities

• Autoimmune diseases, in which the body’s system that fights illness attacks itself instead. These can include hypothyroidism, multiple sclerosis, and lupus

• Chronic fatigue syndrome (CFS) and fibromyalgia

• Being more likely to get infections and mononucleosis

• Mitral valve prolapse, a condition in which one of the heart’s valves does not close as tightly as normal

• Frequent yeast infections

• Certain cancers, such as ovarian, breast, endocrine, kidney, thyroid, brain, and colon cancers, and melanoma and non-Hodgkin’s lymphoma

What causes endometriosis?

It has not been determined exactly what causes endometriosis, however doctors have identified some risk factors:

• Never having had children

• Menstrual periods that last more than seven days

• Short menstrual cycles (27 days or less)

• A family member (mother, aunt, sister) with endometriosis

• A health problem that prevents the normal passage of menstrual blood flow

• Damage to cells in the pelvis from an infection

Because certain GYN cancers may occur at a higher rate among women with endometriosis, talk to your gynecologist or OB/GYN if you are experiencing any symptoms or risk factors related to endometriosis.

How is endometriosis diagnosed?

Diagnostic tests your gynecologist or OB/GYN may perform include:

• Pelvic Exam

• Ultrasound

• Laparoscopy – likely only to be used if medication is not effective

How is endometriosis treated?

Treatment for endometriosis depends on the extent of the condition, symptoms experienced, and whether you want to have children.

In some cases of endometriosis, medications or NSAIDs (nonsteroidal anti-inflammatory drugs) may be used to relieve pelvic pain. In some women, birth control pills and other hormonal therapies have slowed the growth of the endometriosis.

For more serious cases, when medical and hormonal therapies fail, endometriosis resection surgery may be required to remove the endometriosis implants and the scar tissue caused by the condition. At Hoag, we offer the most advanced surgical options available for treating endometriosis, including minimally invasive options such as laparoscopic and GYN robotic surgery.

Hoag’s GYN robotic team is recognized as a Center of Excellence in Robotic Surgery (COERS) by the Surgical Review Corporation for demonstrating unparalleled commitment and ability to consistently deliver safe, effective, evidenced-based care. Hoag is committed to providing the highest-quality care to its patients through expert use of the da Vinci® Surgical System.

The combination of technological advancements provided by robotic-assisted surgery ensures the surgery is much easier to perform.

Additional benefits to GYN robotic-assisted surgery include:

• Less post-operative pain and scarring

• Decreased blood loss and lower risk of blood transfusion

• Lower risk of infection

• Shorter hospital stay

• Faster return to normal activities

Can I get pregnant if I have endometriosis?

Yes. While endometriosis can affect fertility, most patients with endometriosis can get pregnant spontaneously. Symptoms of endometriosis may subside or go away entirely for a while during pregnancy. Talk to your OB/GYN about your plans to start a family if you have endometriosis.