What is Endometriosis?
Endometriosis is common but also commonly misunderstood. It affects one
in 15 women, or 5 million Americans! Four in 10 of them will be infertile
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 20s or 30s, 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
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 of 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 pregnancy.
If you think you have endometriosis, talk to your doctor sooner rather than
Created: 8/14/2003  - Donnica Moore, M.D.