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 is 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, it is believed that 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.
Endometriosis is also difficult to diagnose conclusively without a surgical
procedure called a laparoscopy.
[A laparoscopy 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
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Created: 10/19/2001  - Donnica Moore, M.D.