Endometriosis
According to the Endometriosis Foundation of America, Endometriosis is a common health problem for women affecting more than 6 ½ million women in the United States. The Newton-Wellesley OB/GYN team is very experienced in diagnosing and treating endometriosis and offers effective treatments and testing methods, including transvaginal ultrasounds, pelvic laparoscopies, and pelvic exams. With two locations in Newton and Walpole, Massachusetts, our OB/GYN physicians are here to help.
Overview of Endometriosis
Endometriosis occurs when the endometrium, the tissue lining your uterus, begins to grow outside the uterus.
This uterine tissue can grow on the ovaries, Fallopian tubes, and other surrounding pelvic organs. Less commonly, the tissue can grow in the bladder, intestine, bowel, appendix, or rectum. In rare cases, it is present outside of the abdominal cavity in the brain or lungs.
Endometriosis can also develop in scars left from surgery on pelvic organs, but it most commonly affects women in the prime of their child-bearing years, between the ages of 25 and 35.
Doctors often misdiagnose the condition because symptoms are similar to other conditions. Some women might not even receive a diagnosis for many years.
Symptoms of Endometriosis
Some of the symptoms of endometriosis include:
- Chronic fatigue
- Pain during intercourse
- Nausea or vomiting
- Severe menstrual cramps
- Moderate to severe pelvic pain
- Longer and heavier menstruation
In more severe cases, endometriosis can lead to bowel and urinary disorders, and even infertility.
Diagnosing Endometriosis
During your consultation, your Newton-Wellesley OB/GYN specialist will ask you questions about your medical history and about your symptoms. Your doctor will also conduct a pelvic exam to feel for large cysts or scars behind your uterus. Other tests may be ordered as well, which may include:
- Transvaginal Ultrasound. Checks for ovarian cysts from endometriosis.
- MRI. Takes a picture of your reproductive organs.
- Laparoscopy. Looks inside your pelvic area to see endometriosis tissue.
Treatment Options for Endometriosis
Endometriosis cannot be cured, but there are treatment options available to alleviate pain and remove lesions.
Endometriosis treatments depend on the severity of the condition and your symptoms, your age, and whether or not you want children. Treatment options include lifestyle changes, pain medications, including over-the-counter medications as well as prescription medications; hormone therapy; or surgical treatment.
Hormone therapy comes in the form of a pill, a shot or injection, or a nasal spray. Therapy aims to treat endometriosis-associated pain. Treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation. Hormone therapy is used in some cases to balance and regulate the hormones that can worsen endometriosis.
If you are not trying to get pregnant, hormonal birth control is a good option for you. Some options may include
- Hormonal IUDs. These help to reduce pain and bleeding and protect against pregnancy for up to 7 years. Note that this treatment may not alleviate pain and bleeding due to endometriosis for that long.
- Extended-cycle (you only have a few periods a year) or continuous cycle (you have no periods) birth control. These options are available in the pill or the shot form to help stop bleeding and reduce or eliminate pain.
If you are trying to get pregnant, your doctor may prescribe
- Gonadotropin-releasing hormone (GnRH) agonists. These agonists block the menstrual cycle, lower the amount of estrogen your body makes, and help with pelvic pain. The treatment causes a temporary menopause, but it also helps control the growth of endometriosis. Once you stop taking the medicine, your menstrual cycle returns, and you have a better chance of getting pregnant.
Surgical treatment is an option for women who have severe symptoms, have not had significant relief from hormone therapy, or have fertility problems. Surgical treatments can provide significant pain relief from endometriosis, although it can be short-term, with endometriosis growths and pain returning over time.
Because some surgical procedures cannot be reversed and others can affect a woman’s fertility, It is important to have a thorough discussion about surgical treatment options with your health care provider. Some of your options may include:
- Laparoscopy. The surgeon removes the lesions and scar tissue without harming the healthy tissue around it through small incisions made in the abdomen.
- Hysterectomy. The surgeon removes the uterus if the ovaries have endometriosis on them or if the damage is severe. Depending on the severity of the condition, the surgeon may also remove the ovaries and Fallopian tubes along with the uterus.
For women who do not want a hysterectomy, your doctor may recommend
- Endometrial Ablation. This procedure involves removing the inner uterine lining, or endometrium to reduce pain and anemia in women who have not found relief from other treatments.
Endometriosis Treatment at Newton-Wellesley OB/GYN
Endometriosis FAQs
Even though endometriosis growths are benign (non-cancerous), they can still cause pain and health problems. This is because the tissue similar to the lining of the uterus grows outside of the uterus, and when the growths swell and bleed and have no way to get out of your body, this causes pain.
You can’t prevent endometriosis, but you can manage your symptoms or reduce your chances of developing it by lowering the levels of the hormone estrogen in your body. Estrogen is known to thicken the lining of your uterus during your menstrual cycle.
It is not clear to researchers yet why endometriosis causes infertility; however, some studies suggest that as the disease progresses endometrial lesions block the fallopian tubes and inhibit ovulatory functioning. Other studies suggest that endometriosis may alter the uterus in a way that disrupts embryo implantation, but further research is needed to understand this more clearly.
