What is Endometriosis
Endometriosis is a condition in which the tissue that lines the uterus (endometrium) grows outside of its normal location. The tissue may grow in many locations close to the uterus, but it commonly grows on the ovaries, fallopian tubes, vagina, or bowel.
When the uterus sheds the endometrium every menstrual cycle, there is bleeding wherever the endometrial tissue is located. This can cause pain because blood is irritating to tissues that are not normally exposed to it.
What are the causes?
The cause of endometriosis is not known.
What increases the risk?
You may be more likely to develop endometriosis if you:
- Have a family history of endometriosis.
- Have never given birth.
- Started your period at age 10 or younger.
- Have high levels of estrogen in your body.
- Were exposed to a certain medicine (diethylstilbestrol) before you were born (in utero).
- Had low birth weight.
- Were born as a twin, triplet, or other multiple.
- Have a BMI of less than 25. BMI is an estimate of body fat and is calculated from height and weight.
What are the signs or symptoms?
Often, there are no symptoms of this condition. If you do have symptoms, they may:
- Vary depending on where your endometrial tissue is growing.
- Occur during your menstrual period (most common) or midcycle.
- Come and go, or you may go months with no symptoms at all.
- Stop with menopause.
Symptoms may include:
- Pain in the back or abdomen.
- Heavier bleeding during periods.
- Pain during sex.
- Painful bowel movements.
- Infertility.
- Pelvic pain.
- Bleeding more than once a month.
How is this diagnosed?
This condition is diagnosed based on your symptoms and a physical exam. You may have tests, such as:
- Blood tests and urine tests. These may be done to help rule out other possible causes of your symptoms.
- Ultrasound, to look for abnormal tissues.
- An X-ray of the lower bowel (barium enema).
- An ultrasound that is done through the vagina (transvaginally).
- CT scan.
- MRI.
- Laparoscopy. In this procedure, a lighted, pencil-sized instrument called a laparoscope is inserted into your abdomen through an incision. The laparoscope allows your health care provider to look at the organs inside your body and check for abnormal tissue to confirm the diagnosis. If abnormal tissue is found, your health care provider may remove a small piece of tissue (biopsy) to be examined under a microscope.
How is this treated?
Treatment for this condition may include:
- Medicines to relieve pain, such as NSAIDs.
- Hormone therapy. This involves using artificial (synthetic) hormones to reduce endometrial tissue growth. Your health care provider may recommend using a hormonal form of birth control, or other medicines.
- Surgery.
This may be done to remove abnormal endometrial tissue.
- In some cases, tissue may be removed using a laparoscope and a laser (laparoscopic laser treatment).
- In severe cases, surgery may be done to remove the fallopian tubes, uterus, and ovaries (hysterectomy).
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Do notdrive or use heavy machinery while taking prescription pain medicine.
- Try to avoid activities that cause pain, including sexual activity.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You
have pain in the area between your hip bones (pelvic area) that
occurs:
- Before, during, or after your period.
- In between your period and gets worse during your period.
- During or after sex.
- With bowel movements or urination, especially during your period.
- You have problems getting pregnant.
- You have a fever.
Get help right away if:
- You have severe pain that does not get better with medicine.
- You have severe nausea and vomiting, or you cannot eat without vomiting.
- You have pain that affects only the lower, right side of your abdomen.
- You have abdominal pain that gets worse.
- You have abdominal swelling.
- You have blood in your stool.
