For many women, painful periods are a fact of life. But when the pain is so bad that you miss school or work, that’s not normal and you should see an OB/GYN for evaluation.
Endometriosis is when the cells that form the lining of the uterus are found outside of the uterus. These cells can be found in multiple different places. They can be found in the ovary, fallopian tubes, on the outside of the uterus, or even on the appendix! About 1 in 10 reproductive age women suffer from endometriosis
Endometriosis can rear its ugly head in multiple different ways. Most commonly, women with endometriosis have chronic pain that occurs around the time of their menstrual period. If their bladder or bowels are involved, a woman with endometriosis can have pain with bowel movements or with urination. Additionally, women when endometriosis can have pain with sexual intercourse.
Occasionally, women with endometriosis can have difficulty getting pregnant and infertility is the only sign that they suffer from this disease.
If an OB/GYN suspects that a patient has endometriosis, they may start with a physical exam to look for masses or any tender spots. To truly diagnose someone with endometriosis, a diagnostic laparoscopy (surgery to look inside the abdomen) with biopsy must be completed.
Treatment of endometriosis is wide-ranging and is dependent on how bad/how much disease there is inside the abdomen. There are both medical and surgical options for treatment. Normally medical options are attempted first, followed by surgical management.
Medical options for treatment of endometriosis include pain killers (NSAIDs like ibuprofen), birth control pills (combine or progestin-only pills) and GnRH blockers. Hormonal medications are most often used to slow the growth of the endometrial cells with the goal of stopping formation of scar tissue. These medications do not typically cure endometriosis, but rather control what is already there.
Surgical removal of endometrial implants can result in decreased pain and can help with infertility issues. Although surgery can be helpful, it is possible that the pain will come back because it is not always possible to see endometriosis and new implants can form.
Surgery in combination with medical management of endometriosis can result in a longer time without pain and is often the most beneficial.