What Women Need to Know about Endometriosis
Women, if you have endometriosis, you are not alone. It is one of the most common gynecological diseases, affecting approximately one in 10 American women. That translates to more than five million women who experience chronic pelvic pain, spotting between periods, severe menstrual cramps, painful intercourse, heavy menstrual periods, and, for some, infertility.
Endometriosis occurs when tissue that normally lines the uterus grows outside in other areas. Most endometriosis is found in the pelvic cavity on or under the ovaries, behind the uterus, on the bowels or bladder, and on tissues that hold the uterus in place. During a period, misplaced endometrial tissue goes through the same changes as tissue that lines the uterus. These growths tend to grow and get bigger during each monthly cycle because there is no place for the built-up tissue and blood to exit the body. Symptoms of endometriosis worsen over time, and can eventually lead to scarring and inflammation.
Women at greater risk for developing endometriosis may have:
- Heavy periods
- Started menstruating at a young age
- Have periods that last longer than one week
- Have a monthly cycle that repeats in fewer than 27 days
- Have a close relative with the disease
There is no cure for endometriosis, but it usually stops when periods end after menopause. Fortunately, there are ways to manage and treat this painful condition.
Women with mild symptoms may find relief from over-the-counter or prescription pain relievers. Hormone therapy may be recommended for women with small growths and minimal pain. Hormones work by stopping a woman from having a normal menstrual cycle, thus preventing the growth of abnormal endometrial tissue. Examples of hormone therapy include birth control pills, progesterone, Danazol (a weak male hormone), and gonadatropin-releasing hormone. This form of therapy works as long as treatment continues, but symptoms may return once a woman stops taking hormones.
Surgery may be the best option for women with extensive endometriosis, severe pain or fertility problems. Laparascopy is used to diagnose or treat endometriosis without making large abdominal incisions. During the procedure, doctors make two small cuts and use special equipment to either remove growths and scar tissue, or destroy them with intense heat. Healthy tissue is not harmed during a laparascopy. Major abdominal surgery, or laparotomy, involves making a much larger cut to reach and remove growths. In some cases, the uterus is removed during a surgical procedure called a hysterectomy.
Approximately 30 to 40 percent of women who have endometriosis have difficulty becoming pregnant. For them, in vitro fertilization has been effective in improving fertility. However, other forms of hormone therapy are not as successful in treating infertility.
Endometriosis is not the same as endometrial cancer, a type of cancer that affects the lining of the uterus, nor is there any proven link between the two diseases. However, a woman should always be aware of changes in her body and discuss any concerns with her physician.
For more information about endometriosis, visit the website for the National Women’s Health Information Center at www.womenshealth.gov.