Endometriosis occurs when growth of the tissue that lines the inside of the uterus (endometrium) is found outside of the uterus in other areas of the body. It can only occur after menstruation begins in a woman. Endometriosis is very common. Women in their 20s, 30s, and 40s are most likely to get it.
Symptoms
Most of the time women with endometriosis have no symptoms. When symptoms are
present, the most common ones are:
Pain before and during menstrual
periods (usually worse than the pain in "normal" menstrual cramps)
Pain during or after sexual intercourse
Painful urination
Lower back pain and painful bowel movements
or loose stools with menstrual periods
Pelvic soreness/tenderness
Pain, however, is not always present. Other symptoms include:
Premenstrual vaginal spotting of
blood
Abnormally heavy or long menstrual periods
Infertility
The exact cause of endometriosis is unknown. One theory suggests that some of the
lining of the uterus during menstruation moves backwards through the fallopian tubes into
the abdominal cavity where it attaches and grows. Other theories point to problems with
the immune system and/or hormones. There is also some evidence that the condition may be
inherited. Places where endometriosis is commonly found are:
The outside surface of the uterus
Fallopian tubes
Ovaries
The lining of the pelvic cavity
The area between the vagina and the rectum
An accurate diagnosis of endometriosis must be made by your gynecologist. He or she may perform a laparoscopy, which is an outpatient surgical procedure. A slim telescope is inserted through a very small opening made in the navel. This allows your doctor to examine the abdominal and pelvic organs and evaluate the extent of the disease.
Treatment
The management of endometriosis is aimed at suppressing levels of the
hormones estrogen and progesterone. These hormones cause endometriosis to grow. Mild to
moderate endometriosis may be relieved at menopause.
Treatment for endometriosis can include surgery or medication therapy.
Surgery:
Conservative surgery, such as removing areas of endometriosis using laser, cautery, or
small
surgical instruments to destroy the growths.
These methods are used to reduce pain and to allow
pregnancy to occur in some women.
Nonconservative surgery which removes the ovaries. The fallopian tubes and uterus can also
be
removed. Surgeries of this kind would likely
eliminate pain, but leave a woman unable to conceive.
Medication therapy:
Pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs). These include
ibuprofen
and naproxen sodium.
Oral contraceptives given in a specific regimen to temporarily stop ovulation and
menstruation. They
are more likely to be used for very mild
cases of endometriosis.
Antiestrogens, which suppress a woman's production of estrogen. This will stop the
menstrual cycle
and prevent further growth of endometriosis
since endometriosis needs estrogen to grow. These can
have side effects such as acne, hair growth
on the face, and changes in the libido.
Progesterone, which is used to cast off the endometrial cells and thus destroy them
Gonadotropin-releasing hormone (GnRH) agonist drugs, which will stop the production of
estrogen.
This causes a medically induced menopause
that is temporary.
| Do you have premenstrual spotting of blood and/or abnormally heavy or long menstrual periods? |  |
Do you have a lot of pain at any of these times? During sex When you menstruate and this has gotten
worse over time When you urinate |
|
| Have you tried to get pregnant, but have not been able to in 12 or
more months? |
|
Self-care is very limited for endometriosis. It needs medical treatment. Things
you can do to enhance medical treatment include:
Exercise regularly.
Eat a diet high in nutrients and low in
fat, especially saturated fat, mostly found in coconut and palm oils, animal sources of
fat, and hydrogenated vegetable fats.
Take an over-the-counter medicine for pain.
Check with your doctor for his/her preference. {Note: See Pain relievers in "Your Home Pharmacy".}
Consider using oral contraceptives for
birth control. Women who take the pill are less likely to have endometriosis.
HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine.
Date updated 04/21/99