Every woman with a normal menstrual cycle sheds the lining of her uterus approximately every 28 days. You know this as your monthly period.
Endometriosis happens when the lining of the uterus, called the endometrium, spreads outside the uterus, unrelated to a normal monthly period. The endometrium may attach to your ovaries or on nearby intestines and ligaments in your pelvis. Endometriosis may occur in flat patches, or it may grow into large and small cysts.
At its worst, endometriosis can spread widely throughout the pelvic region and bind together with the uterus, fallopian tubes, ovaries or other intestines and tissues. Chronic endometriosis can lead to scarring of these body parts, which may damage your reproductive organs and affect your ability to become pregnant.
The most common symptoms are:
- Painful periods
- Pain with intercourse
- Pelvic pain
Some women with endometriosis don't have symptoms.
Talk to your doctor if you have any of the above symptoms. Your doctor may use one or more of the following diagnostic tests to see if you have endometriosis:
- Laparoscopy – This minimally invasive procedure uses a small tube that's inserted through your belly button to view inside your pelvis and check your reproductive organs for signs of endometriosis.
- Pelvic exam – Patches of endometrium found on the cervix or in the vagina, or evidence of the uterus or ovaries being fixed in place due to endometrium adhesions, may be signs that you have endometriosis.
- Ultrasound – Viewing the uterus using an ultrasound may help determine if endometrium cysts are present.
Treatment options for endometriosis
You don't have to live with the pain and infertility caused by endometriosis. Your doctor can help you find solutions to manage pain or get rid of symptoms entirely. Treatment options may include:
- Hormonal therapy – Using progesterone to mimic the state of pregnancy or menopause may help ease endometriosis.
- Oral contraceptives – Commonly known as "the pill," oral contraceptives can help with symptoms of endometriosis, such as extreme cramping.
- Medications – Over-the-counter, anti-inflammatory medications, such as ibuprofen and aspirin, may help with painful symptoms of endometriosis.
- Surgery – Minimally invasive, laparoscopic surgery may be needed to scrape away the endometrium that has spread within the pelvic region. Many times, women who are infertile because of endometriosis are able to become pregnant right away after having this procedure.
When infertility is the main concern, fertility drugs, artificial insemination and in vitro fertilization may also be advised as treatment options.
In extreme cases, women who are no longer concerned with fertility may need to have all or some of their reproductive organs removed to completely resolve endometriosis.