Endometriosis is a painful disorder that involves your fallopian tubes, ovaries, and the tissue lining the inside of your pelvis. The disease occurs when the tissue inside of your uterus known as endometrium, grows outside of your uterus.
Displaced endometrial tissue will continue to act as it normally should by breaking down, thickening, and bleeding during each menstrual cycle. The displaced tissue will have no way to exit your body, so it becomes trapped. If the displaced tissue involves the ovaries, cysts are likely to form called endometriomas. The tissue surrounding the area becomes irritated and will eventually develop scar tissue as well as adhesions. These abnormal bands of fibrous tissue can cause organs and pelvic tissue to stick together.
What are the Symptoms of Endometriosis?
Endometriosis can cause severe pain, which is especially intense during the menstrual cycle. A woman can develop fertility problems from this disorder, but there are effective treatments available. The main symptom of endometriosis is pain in the pelvic area. Cramping is a common experience during the menstrual cycle for many, but those who have endometriosis, the pain is extremely worse. The pain can become more severe; the longer the disorder goes untreated.
Signs and symptoms of endometriosis include:
Pain after or during sexual intercourse is common with the endometriosis disorder
Occasional heavy menstrual periods or bleeding between cycles is another common symptom
Endometriosis is often first diagnosed when a woman seeks treatments for infertility
Dysmenorrhea (painful periods)-
Cramping and pelvic pain may start before your menstrual period and extend several days into the cycle. During the cycle, you may also experience abdominal and lower back pain.
Painful urination or bowel movements-
Pain during urination or bowel movements are most likely experienced during the menstrual cycle and are an indication you’ve developed endometriosis
The severity of pain with this disorder is not an indication of the extent of your condition. It is possible to have a mild case of endometriosis and suffer from extreme pain. It is just as possible to have an advanced case and experience little to no discomfort. The pain levels sometimes cause endometriosis to be mistaken for other conditions.
Pelvic inflammatory disease is a condition that also causes intense pelvic pain, as well as ovarian cysts, and sometimes is confused with endometriosis. Endometriosis can also be confused with irritable bowel syndrome where a person will suffer from bouts of diarrhea, abdominal cramping, and constipation. Irritable bowel syndrome (IBS) sometimes accompanies endometriosis, which is why the diagnosis can become complicated.
You should schedule an appointment with your doctor if you experience signs or symptoms of endometriosis. This disorder is a challenging condition, but your doctor at All Women’s Care can help establish better management of your symptoms when diagnosed early.
How to Diagnosis Endometriosis
Your doctor will begin by asking you to describe your symptoms and asking you where your pain is generating from. Some tests can be performed as well to diagnosis endometriosis:
An ultrasound uses high-frequency sound waves that are able to create images of the inside of your body. A device called a transducer captures the images by being pressed against your abdomen. The transducer can also be inserted into your vagina, which is called a transvaginal ultrasound.
Either method can be done to provide a view of your reproductive organs. The standard ultrasound imaging does not give specific information for your doctor to diagnose endometriosis. What the ultrasound can offer is an identification of any cysts that exist which are associated with the disorder.
MRI (Magnetic Resonance Imaging)
An MRI uses a magnetic field and radio waves during an exam to create detailed images of your organs and tissues in your body. MRIs help to plan surgeries by providing the surgeon with detailed information concerning the size and location of endometrial implants.
A pelvic exam will allow your doctor to palpate areas in your pelvis to search for abnormalities manually. The exam is to look for cysts on your reproductive organs and scars behind your uterus. This exam does not often reveal small areas of endometriosis unless a cyst has already formed.
A surgical procedure called laparoscopy allows a surgeon to see inside your abdomen. General anesthesia is used, and the doctor makes a small incision near your navel to insert a small viewing instrument. The instrument will provide the view of your organs, so the surgeon can diagnose endometriosis if it is located.
How to Treat Endometriosis
There is not a cure for endometriosis, but there are ways to ease the pain this disorder causes. There are different medicines from those prescribed by your doctors at All Women’s Care to those you can find over-the-counter.
If your pain is mild, you may likely be directed to take a pain reliever such as a non-steroidal anti-inflammatory drug (NSAID) such as naproxen or ibuprofen. If the pain is severe and the over-the-counter relievers are not working, you should speak with your doctor and consider a prescription for a stronger form of pain relief.
Hormone therapy is another form of treatment if the pain medicines are not working to ease your discomfort. Your doctor can prescribe medications that will reduce the amount of estrogen your body produces. Some meds are able to control or prevent your menstrual cycles, which will make the area affected by endometriosis bleed less. When your period is interrupted, and you bleed less, inflammation is cut down and scarring, or ovarian cysts are reduced.
Some of the common hormones doctors use to control endometriosis include:
Contraceptives used to control endometriosis are; birth control pills, vaginal rings, and patches. These products all contain progestin and estrogen.
Medicines that affect the gonadotropin-releasing hormone can be taken either as a shot or through a nasal spray. Doctors often refer to these as GnRH antagonists or agonists and can be used for only six months due to their side effects. It is not safe to use GnRH agonists for more than six months as it could affect your bones and heart.
Progestin-only contraceptives include shots, an IUD, and pills. These medicines cut down on pain as most women taking these meds to have fewer periods or do not have a period at all.
Danazol stops your body from releasing hormones that bring about the start of your menstrual cycle. When taking this medication, you will need to use a birth control method to prevent pregnancy. If pregnancy occurs while taking danazol, it could cause a female baby to have male traits.
Hormone therapies have side effects such as depression, weight gain, body hair, irregular bleeding, and acne. You should talk with your doctor about your pain levels from the endometriosis and the possible side effects of the hormone treatments to decide which is the better course of action for you. Speak with All Women’s Care to learn about the benefits and risks and the best treatment for your pain.
Aromatase boosts your body’s estrogen production. These chemical inhibitors block the production, so your estrogen levels are lower. These medications are not routinely used in treating endometriosis; however, there are times when a doctor will recommend it ‘off label.’ These inhibitors are used in addition to other hormone treatments to help in managing endometriosis pain. This treatment is possible as long as you are not planning a pregnancy.
Is Surgery an Option for Endometriosis?
If your endometriosis is severe enough to the point where pain medications are not helping, you may consider surgery. Some of the tissue inside your body may need to be removed to reduce your pain; however, there are considerations you should know about.
Some of the operations for endometriosis can permanently affect whether or not you will be able to have children. Speak with your doctor at All Women’s Care to find out if this option is one you would consider. If surgery is the option you want to use, it will depend on your condition and age to determine if you are a good candidate. These factors should also be considered:
- If you have a growth in your pelvic area that your doctor feels needs removing, then surgery would be a good option
- If the medications for pain relief are not working and the pain is affecting your daily routines or quality of life, you may want to consider surgery
- Having severe pelvic pain that is not controllable with medications, or
- You are not able to get pregnant due to scarring or tissue that is hindering your chances of pregnancy; you might want to consider the surgery
Laparoscopic Surgery for Endometriosis
Laparoscopy surgery is a common surgical procedure used to diagnose and remove mild to moderate endometriosis. Your doctor will inflate your abdomen with gas and then make a small incision in which to insert a laparoscope. A laparoscope is a lighted viewing instrument the doctor can use to view your internal organs.
Using the laparoscope is the only way in which the doctor can diagnose a case of endometriosis for certain. If located, any visible implants of endometriosis along with noticeable scar tissue that may be causing infertility or severe pain can be removed. Should the doctor discover the endometriosis is growing on your ovary, it likely has to be removed.
Before a laparoscopy procedure is done, your doctor will ask that you do not eat or drink for at least eight hours before the surgery. The procedure will be done under local anesthesia; however, if you want to remain awake, you can request a local or spinal.
The gas used to inflate your abdomen is injected with a needle. The gas or air will push your abdominal wall away from your organs. This process enables the doctor to see them more clearly. Inserting the laparoscope into the small incision will allow them to examine your internal organs and check for signs of endometriosis. The complete procedure is generally done within forty-five minutes.
If there is scar tissue discovered that has to be removed, the doctor will use one of the various methods. The scar tissue can be cut away and removed, or it can be destroyed by using a laser beam or electric current. Once finished with the removal, the surgeon will then close the abdominal incision with a few stitches. There is generally no scarring after this surgery.
Why Choose Surgery for Endometriosis?
Endometriosis is generally treated with pain medications. There are cases of this disorder where pain medicines will not work to control the severity of the pain, or endometriosis is interfering with a woman’s chances of having a baby. Other reasons may exist, making you want to choose laparoscopy surgery to treat your endometriosis, including:
- There are cases of endometriosis where the scar tissue begins to interfere with internal organs such as the bladder or bowels. It is then necessary to use surgery to restore these functions to normal use.
- Some hormone therapies will not relieve a person’s pain. To control and be able to live with endometriosis, some of the scar tissue has to be surgically removed to reduce or eliminate the severe pain. This removal can only be done through the laparoscopy procedure.
- When endometriosis pain is too severe, your doctor may choose to have you skip the medication or hormone treatments. They may suggest surgery as the first choice for pain control
- If an endometriosis cyst has grown on one of your ovaries, it needs to be removed.
- Endometriosis can cause infertility. A surgeon can remove visible implants and scar tissue that may be the cause of a woman not being able to have a child.
Laparoscopy surgery can be done as an outpatient procedure. Some situations occur where a surgeon may ask that you spend one day in the hospital; however, you should be able to return to your normal daily schedule within one week of the surgery.
Is Surgery a Cure for Endometriosis?
Surgery relieves endometriosis pain just as hormone therapy does; however, there is no cure for this disorder. While the laparoscopy procedure will relieve your pain as it does for most women, it does not guarantee long-lasting results:
- In most women about 75 out of 100 reports they experience pain relief in the first months after surgery
- About 60 women out of 100 women report their symptoms to return within two years after surgery. This number has increased over time.
Studies suggest that if hormone therapy is used after laparoscopic surgery, the pain-free period can last longer. The therapy prevents the new growth of or return of endometriosis.
Infertility and Endometriosis
For some women, infertility is the main issue of having endometriosis. All Women’s Care may be able to use laparoscopy surgery to find and remove signs of this disorder if it is causing infertility. There are some factors to consider when thinking about surgery for this reason:
- It has not been proven through research that by removing mild endometriosis will improve your chances of having a child.
- Your chances of having a child are improved if your endometriosis is mild to moderate when you have the surgery.
- If your endometriosis is severe, chances are a fertility specialist will advise you to skip the surgery, and use in vitro fertilization to obtain a pregnancy.
If you decide to have laparoscopic surgery to improve your chances of pregnancy, your next step will depend on your age and the severity of your condition. Women older than the age of 35 experience a decline in their egg quality, and are at a higher risk for miscarriage. If this is your situation, it may be suggested you use infertility treatments such as insemination, fertility drugs, or as mentioned earlier, in vitro fertilization. Women younger than 35 can attempt conception without infertility treatments.
Hysterectomy to Treat Endometriosis
At one time, removing the uterus and ovaries (surgical hysterectomy) was thought to be the most effective treatment for endometriosis. This approach is no longer considered the best option, and doctors feel the removal of the endometriosis tissue works the best.
When a woman has her ovaries removed, it results in menopause. The ovaries produce hormones, and when they are removed, there is a lack of hormones. This lack of hormones can improve endometriosis pain in some patients, but it is not a guarantee as some women continue to suffer symptoms even after the surgery. If menopause occurs early in a woman’s life, it carries serious risks. These risks include certain metabolic conditions, a cardiovascular disease involving the heart and blood vessels.
A hysterectomy can sometimes treat endometriosis when symptoms are associated with the disorder such as painful menses due to uterine cramping or heavy menstrual bleeding. A woman would have to have given up the idea of having children to consider this option. In situations where the uterus is removed, but the ovaries are left in place, this form of hysterectomy has a long-term effect on a woman’s health. Women who have this procedure before they turn 35 are at a higher risk for adverse health conditions.
Endometrioma is a cyst that forms when your endometrial tissue grows in your ovaries. The tissue is the mucous membrane in the inner layer of your uterine wall. Endometrioma affects women during their reproductive years and can cause pelvic pain during the menstrual cycle.
There are surgical procedures to treat endometrioma. One method is to drain it, another is to cut out part of it, and there is also performing a cystectomy to remove it completely. Cystectomy is the one procedure most likely to relieve pain for a more extended time. This procedure will also prevent an endometrioma from returning, which would prevent the need for further surgeries.
As with all surgeries, cystectomy surgery does include some risks:
- There is a risk for pelvic infection
- A chance for uncontrolled bleeding exits, which could lead to the need for a larger incision in your abdomen to stop the bleeding
- There is a risk of scar tissue could form after surgery
- There is a risk for damage occurring to the ureters, bladder, or bowel. These are the small tubes that carry urine from your kidneys to your bladder.
Endometriosis Pain and How to Cope
The most challenging symptom of endometriosis is the pain it causes. The pain can sometimes become so severe it sidelines you from your daily activities, and the tasks you have to complete. Pain medications and medical treatments such as surgery or hormone therapies can help you curb the pelvic pain associated with the growth occurring along your reproductive tract. There are other options for you as well to help you cope with endometriosis pain.
p>Lifestyle changes, including lessening your stress can help you maintain mental health and manage pain. Your emotional health has a significant impact on your pain levels:
- In cases of severe endometriosis pain, it has been linked to both stress and depression
- When you experience severe pain, it affects your quality of life
- An essential piece of a pain management plan is to maintain mental wellness
Keeping stress in check involves:
- Treating your body well by getting regular sleep, eating a nutritious diet, and exercising regularly. When you experience fat loss through exercise, it will reduce estrogen levels and improve your endometriosis symptoms.
- Have a positive attitude by thinking about encouraging thoughts.
- Seek support through your doctor at All Women’s Care and know you don’t have to deal with the pain on your own.
Heat therapy is effective in fighting endometriosis pain. Heat increases blood flow and will allow your muscles to relax, which in turn will reduce pain. This form of therapy is safe and will complement your medications used to ease endometriosis pain. To perform heat therapy, you need to fill a bathtub with warm water and soak or apply a heating pad or hot pack to the pelvic area.
Find Treatment for Endometriosis Near Me
If you feel the pain you are suffering is related to endometriosis, call All Women’s Care at 213-250-9461 to set up an appointment and discuss your options. We can guide you through the process of determining if your symptoms are related to this disorder. If you are suffering from endometriosis, we are here for you to help deal with the pain.