Endometriosis

WHAT IS IT?
Endometriosis is an often painful disorder in which tissue that normally lines the inside of the uterus (endometrium) spreads and grows outside the uterus. Rarely, endometrial tissue may spread beyond the pelvic region.

The displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because the tissue has no way to exit your body, it becomes trapped. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions.

SYMPTOM

• Painful periods. Pelvic pain and cramping may begin before and extend several days into your period.
• Pain with intercourse. Pain during or after sex is common.
• Pain with bowel movements or urination. These symptoms are most common during your period.
• Excessive bleeding. You may experience occasional heavy periods or bleeding between periods.
• Other symptoms. You may also experience fatigue, diarrhea, constipation, or nausea, especially during menstrual periods.

The main complication of endometriosis isimpaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Ovarian cancer also occurs at higher than expected rates in women with endometriosis.

TREATMENT
In making a diagnosis of endometriosis, your doctor will likely perform a pelvic exam to feel for abnormalities. An ultrasound exam may reveal cysts associated with endometriosis. Sometimes minimally invasive laparoscopic surgery is performed to look for endometrial tissue outside the uterus.
 
The type of treatment you may receive depends on the severity of your symptoms and whether you hope to become pregnant.

• Hormone therapy. Hormone medication may slow the growth of endometrial tissue outside the uterus and prevent new implants. Hormonal contraceptives include birth control pills, patches, and vaginal rings that help control those hormones responsible for the buildup of endometrial tissue each month.
• Conservative surgery. If you’re trying to become pregnant, surgery to remove as much displaced tissue as possible while preserving your uterus and ovaries may increase your chances of success.
• Hysterectomy. In severe cases of endometriosis, surgery to remove the uterus and cervix as well as both ovaries (total hysterectomy) may be the best treatment. Hysterectomy is typically considered a last resort, especially for women still in their reproductive years.

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Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.