What Is Endometriosis?
Endometriosis occurs when tissue that makes up the lining of the uterus (endometrium) grows in other parts of the body. This can cause chronic inflammation that can result in scarring. It is most commonly found in the pelvic cavity and ovaries. Less commonly, these lesions may grow on the intestines and bladder, and rarely they may grow in the lungs or other locations within the body. Growths of endometriosis are almost always benign (non-cancerous).
Endometriosis is a common disorder, most prevalent between the ages of 25 and 40 and affecting an estimated 5 to 10 percent of all women. Symptoms vary and are not strictly correlated with the severity of the disease. Symptoms may worsen with time but tend to diminish during pregnancy and cease with menopause. Many women have no symptoms at all.
Treatment depends on the severity of symptoms, the age of the woman, and whether she wishes to have children.
Endometriosis is a common disorder, most prevalent between the ages of 25 and 40 and affecting an estimated 5 to 10 percent of all women. Symptoms vary and are not strictly correlated with the severity of the disease. Symptoms may worsen with time but tend to diminish during pregnancy and cease with menopause. Many women have no symptoms at all.
Treatment depends on the severity of symptoms, the age of the woman, and whether she wishes to have children.
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Symptoms of Endometriosis
While each woman may experience symptoms of endometriosis differently, the most common symptoms include:
The amount of pain a woman has isn’t always related to the severity of the disease. Endometriosis can be managed with early diagnosis and treatment options. Consult your physician if you're experiencing any of the symptoms of endometriosis.
While each woman may experience symptoms of endometriosis differently, the most common symptoms include:
- Pain and cramps that may be felt in the pelvis, abdomen or lower back during your period and in some cases, can occur at other times during your cycle.
- Pain during or after sex
- Abnormal or heavy menstrual flow
- Difficulty becoming pregnant
- Fatigue
- Painful urination during your periods
- Painful bowel movements during your periods
- Other gastrointestinal problems, such as bloating, diarrhea, constipation and/or nausea
The amount of pain a woman has isn’t always related to the severity of the disease. Endometriosis can be managed with early diagnosis and treatment options. Consult your physician if you're experiencing any of the symptoms of endometriosis.
Causes and Diagnoses of Endometriosis
The exact cause of endometriosis is unknown. It is likely that certain genes play a role, but there are many other contributing factors. Experts do agree that the hormone estrogen promotes the growth of endometriosis, and treatment often focuses on lowering estrogen levels. Specialists suggest that blood from a woman’s period may travel backwards (retrograde menstruation) through the fallopian tubes and into the abdominal and pelvic cavities. Research is looking at how the function of the immune system may also relate to development of this condition.
Risk factors
Endometriosis can develop in any woman, but certain risk factors increase the likelihood of developing this condition, including:
Diagnoses
The only way to diagnose endometriosis is with a surgical procedure called a laparoscopy in which a biopsy (sample of tissue) is obtained. Laparoscopy allows surgeons to visualize the disease and to take a sample that can be evaluated in a laboratory. Currently there are no blood tests that can confirm the presence of endometriosis. However, if endometriosis is suspected based on symptoms, such as persistent painful periods, and examination findings showing possible pelvic nodules, it is generally acceptable to start medical treatment without undergoing a laparoscopy.
In some cases, your physician may need to order alternate imaging (e.g., ultrasound or MRI) to assess other areas that may be affected by endometriosis.
Direct visualization of endometrial tissue with biopsy or sampling of the extrauterine endometrial tissue is done by laparoscopy (the insertion of a thin, lighted camera into the abdomen through a small incision at the belly button).
If you are diagnosed with endometriosis while undergoing laparoscopy, your doctor may remove the endometrial tissue during the procedure.
In some cases, your physician may need to perform alternative tests. Other tests may include:
The exact cause of endometriosis is unknown. It is likely that certain genes play a role, but there are many other contributing factors. Experts do agree that the hormone estrogen promotes the growth of endometriosis, and treatment often focuses on lowering estrogen levels. Specialists suggest that blood from a woman’s period may travel backwards (retrograde menstruation) through the fallopian tubes and into the abdominal and pelvic cavities. Research is looking at how the function of the immune system may also relate to development of this condition.
Risk factors
Endometriosis can develop in any woman, but certain risk factors increase the likelihood of developing this condition, including:
- Family history of endometriosis (mother, aunt, sister or daughter)
- First menstrual cycle (menarche) occurring before the age of 11
- Monthly cycles shorter than 27 days
- Never having given birth (nulliparity) or women who gave birth for the first time after age 30
- Caucasian women
- Women with uterine abnormalities
- Heavy, painful menstrual cycles lasting longer than a week
- Obesity
- Low body mass index (BMI)
Diagnoses
The only way to diagnose endometriosis is with a surgical procedure called a laparoscopy in which a biopsy (sample of tissue) is obtained. Laparoscopy allows surgeons to visualize the disease and to take a sample that can be evaluated in a laboratory. Currently there are no blood tests that can confirm the presence of endometriosis. However, if endometriosis is suspected based on symptoms, such as persistent painful periods, and examination findings showing possible pelvic nodules, it is generally acceptable to start medical treatment without undergoing a laparoscopy.
In some cases, your physician may need to order alternate imaging (e.g., ultrasound or MRI) to assess other areas that may be affected by endometriosis.
Direct visualization of endometrial tissue with biopsy or sampling of the extrauterine endometrial tissue is done by laparoscopy (the insertion of a thin, lighted camera into the abdomen through a small incision at the belly button).
If you are diagnosed with endometriosis while undergoing laparoscopy, your doctor may remove the endometrial tissue during the procedure.
In some cases, your physician may need to perform alternative tests. Other tests may include:
- Biopsy: For this test, a small tissue sample is removed from the body during laparoscopy and examined by a pathologist.
- Ultrasound: This imaging test uses high-frequency sound waves to create an image of the organs.
- Computed tomography (CT) scan: For this imaging test, X-rays and a computer are used to make images (often called slices). It can find problems that may not show up on an ordinary X-ray.
- Magnetic resonance imaging (MRI): This imaging test provides a two-dimensional view of organs or tissue.
Treatments for Endometriosis
Treatment options include medicine, surgery or both. Whether you hope to become pregnant will play a role in your options. If symptoms are mild, you may only need pain medicine. In other cases, hormone-based medicine, such as birth control pills, will stop ovulation and slow endometriosis.
Several surgical options can be used to remove the implants. In some cases, physicians may be able to remove the growths through laparoscopy. In other cases, open surgery is needed. Removal of the uterus may also be necessary for some women.
Endometriosis can make it very hard or impossible for a woman to get pregnant. Sometimes surgery can help. But, in a few cases, women may remain infertile.
Living with endometriosis
Simple steps can help ease the pain of endometriosis, including:
Treatment options include medicine, surgery or both. Whether you hope to become pregnant will play a role in your options. If symptoms are mild, you may only need pain medicine. In other cases, hormone-based medicine, such as birth control pills, will stop ovulation and slow endometriosis.
Several surgical options can be used to remove the implants. In some cases, physicians may be able to remove the growths through laparoscopy. In other cases, open surgery is needed. Removal of the uterus may also be necessary for some women.
Endometriosis can make it very hard or impossible for a woman to get pregnant. Sometimes surgery can help. But, in a few cases, women may remain infertile.
Living with endometriosis
Simple steps can help ease the pain of endometriosis, including:
- Rest, relaxation and meditation
- Warm baths
- Constipation prevention
- Regular exercise
- A hot water bottle or heating pad placed on your abdomen
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Serdar E. Bulun, MD, is a world-renowned specialist in the use of aromatase inhibitors to treat women with endometriosis. Dr. Bulun is joined by a multidisciplinary team at the Women’s Health Center housed under Prentice Women’s Hospital at Northwestern Memorial Hospital. Their team offers leading-edge diagnostic testing as well as personalized treatment plans for women with endometriosis and pelvic pain.
For more information regarding endometriosis and available treatments, please contact our women’s health specialists at Northwestern Medicine Prentice Women’s Hospital at 312.695.1414 or request a first-time appointment online. |
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