What is Endometriosis?
Endometriosis is common but also commonly misunderstood. It affects one in
fifteen women, or 5 million Americans! 4 in 10 of them will have infertility
as a result. Endometriosis may be marked by severe cramping before and during
menses, but some women will be asymptomatic. Classically women are not affected
until their 20's or 30's, but girls as young as 17 have been diagnosed. The
pain of endometriosis is not generally relieved by non-steroidal anti-inflammatory
medications, as is the pain of routine menstrual cramps.
What causes endometriosis? Simply put, some of the lining cells of the womb
flow backward into the pelvis and implant on other tissues, such as the ovaries
or fallopian tubes. Being estrogen sensitive, these implants react cyclically:
they can grow and cause pain, abnormal bleeding and tubal blockage. There are
many things we still don't understand about endometriosis: what causes it in
some women and not others, why the symptoms are not necessarily related to the
size or location of the implants, or how to prevent it. There are also many
other theories about what causes endometriosis.
Endometriosis is also difficult to diagnose conclusively without a surgical
procedure called a laparoscopy: this allows your doctor to look into your abdomen
and pelvis with a lit tube through a small incision beneath your belly button.
This is a major reason this procedure is recommended for women with unexplained
infertility: even mild endometriosis can cause infertility and early treatment
can double a woman's chances of conceiving. If necessary, the gynecologist
can also use lasers to destroy some evident implants or other microsurgical
techniques to remove tubal scarring.
There are effective medical treatments available for endometriosis as well,
although there is no cure. Treatment recommendations will be based upon the
woman's age, her desire for preserving her fertility, the extent of her symptoms,
and the extent of the endometriosis. Sometimes, doctors simply recommend a trial
birth control pills. Next, hormones called danazol or GnRH analogs and antagonists
may be tried. All of these medicines have side effects or limitations, so several
options may need to be tried. And, of course, each of these medications postpone
If you think you have endometriosis, talk to your doctor sooner rather than
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Created: 11/10/2000  - Donnica Moore, M.D.