Conditions
Endometriosis
Over 190 million women globally suffer from endometriosis. This condition not only painfully affects a woman’s monthly cycle but can also heavily affect her fertility. As common as endometriosis is, there are still many misconceptions surrounding this condition. Read to learn more about the causes, diagnosis, and potential treatments to alleviate symptoms.
What is Endometriosis?
Endometriosis is a condition that involves tissue growth outside of the uterus. Endometriosis is derived from the word endometrium, a small layer of the body that prepares an egg to be fertilized. The small endometrium layer is shed when an egg is not fertilized. Every woman sheds the endometrium layer during her menstrual cycle.
The condition occurs when tissue resembling the endometrium layer develops outside the uterus. The abnormal tissue growth builds in areas like the ovaries, the back or front of the uterus, and the fallopian tubes.
Endometriosis Signs and Symptoms
There are many signs and symptoms of endometriosis; one of the main signs is intense pelvic pain during a woman’s cycle. Pain is described as a “sharp, stabbing, aching, twisting, or burning” pain. The sensation is said to feel far more severe than the average cramping during periods.
Common signs and symptoms can include:
Pain during periods is said to be far worse than moderate cramping and soreness. Days before and during the menstrual cycle, those with endometriosis feel pain so extreme it can be debilitating.
Endometriosis tissue does not only grow on the reproductive organs but can also form by the intestines, bladder, and rectum. Bowel endometriosis can involve constipation, bloating, and gas; blood may even appear while urinating.
Dyspareunia, or pain during intercourse, is a typical sign of endometriosis. The constant thrusting can irritate the tender or sore parts where the growth is at. Those who suffer from the condition also state that the pain can last up to two days after sex.
Those who live with this condition experience an excessive amount of bleeding. This bleeding may interfere with daily activities and last longer than seven days.
Retrograde menstruation occurs when blood flows through the fallopian tubes instead of the vagina. When the blood streams to other parts of the body, like the peritoneum (the tissue that covers your abdomen), it can cause excruciating pain.
Other symptoms of endometriosis may include nausea, fatigue, or diarrhea.
Note
Endometriosis can share many characteristics with conditions such as irritable bowel syndrome (IBS) or pelvic inflammatory disease. Consult with your doctor to determine your diagnosis.
How is Endometriosis Diagnosed?
There are a variety of ways this condition is diagnosed. At times, the severity of pain or bleeding determines how a person is examined for the condition. Your doctor may ask you a series of questions that can include where and when you are experiencing pain and ask you to describe other symptoms.
Procedures that may be performed to diagnose endometriosis:
Pelvic exam:
In this procedure, a specialist such as a gynecologist will place their hand and feel for any abnormalities. An abnormality that can be felt during a pelvic exam can be a cyst. When the cyst is touched, this may feel tender or sore.
Ultrasound:
An ultrasound is a medical sonography that utilizes sound waves to produce an image—a tool known as the transducer is placed on the abdomen or a more miniature transducer is inserted in the vagina. Ultrasounds provide a doctor with a potential image if there are any cysts on the reproductive organs.
Magnetic resonance imaging (MRI):
An MRI can be described as a large magnetic scanner that can produce images of muscles, bones, and organs. A person is placed on a table and inserted slowly into a giant machine. The procedure can take up to 20 to 90 minutes at most.
Biopsy (laparoscopy):
A laparoscopy is a common surgery that is performed to diagnose endometriosis. For this procedure, a small incision will be made in the abdomen. Once the incision is made, a small tube with the camera at the head of the tool is inserted into the abdomen to see if there is any abnormal growth of tissue or cysts.
Stages of Endometriosis
There are four different stages of endometriosis established by the American Society of Reproductive Medicine (ASRM). The stages are separated based on a point system. Points are based on the number of implants (pieces of the lining that appear like spots), cysts, or scar tissue.
Stage I (1-5 points): This is classified to be a minimal stage of endometriosis. At this stage, there is a minimal amount of implants. Implants are also superficial and not deeply implanted in the surrounding area.
Stage II (6-15 points): At this stage, the condition is considered mild. There are more endometrial implants, and they are also deeper in the body.
Stage III (16-40 points): When there is a presence of scar tissue, and small cysts on ovaries, and many implants are deeply rooted in the surrounding area, this is classified as a moderate form of endometriosis.
Stage IV (40 points or more): Stage four is the most severe of the endometriosis categories. In this stage, there are multiple implants, large cysts, and deep scarring in the surrounding area.
Several treatments cater to each stage of endometriosis.
Treatment and Medications for Endometriosis
Although endometriosis cannot be cured, many options are provided to relieve pain, alleviate symptoms, and support fertility. Multiple factors would determine what treatment is best, such as the severity of the condition, the severity of symptoms, and if a woman would want to have children.
Hormone Therapy
The hormone therapy primarily used for endometriosis is oral contraceptives (birth control pills). Estrogen is the hormone that supports the growth of endometrial tissue. Oral contraceptives limit the estrogen in the body. Contraceptives can also decrease the size of the tissue. Other hormones used to treat symptoms include progesterone and GnRH analogs.
Pain Medication
Pain medication can be prescribed or purchased at a local pharmacy. Anti-inflammatory drugs (NSAIDS) medications assist with pain levels stemming from endometriosis symptoms. If patients have been taking pain medication for an extended time and still feel excruciating pain, they are encouraged to consult with their doctor.
Surgical Treatments
A laparoscopy is performed to remove scar tissue, cysts, and other growths that come with endometriosis. A laparoscopy can be used to view the area to understand what is causing the issues, but it is also utilized to remove endometrial growths. The other procedure performed in an extreme scenario would be a hysterectomy. A hysterectomy is the removal of a woman's womb.
Endometriosis and Infertility
According to the American Society of Reproductive Health, “Up to 30% to 50% of women with endometriosis may experience infertility.” Ways that endometriosis can affect fertility through blockages. When there are any blockages in the fallopian tubes, it can affect sperm traveling to an embryo or affect the egg traveling to the uterus.
Although it may be challenging to conceive for women with endometriosis, it is not impossible, especially with fertility assistance. One type of fertility assistance that can increase the probability of a woman with endometriosis can be in-vitro fertilization (IVF). IVF encourages ovarian stimulation and the release of numerous mature eggs. After eggs have matured, they are collected from a woman and then fertilized in a laboratory.
Reproductive Fertility Center has been helping women with infertility challenges grow their families through procedures like in-vitro fertilization, intrauterine insemination, embryo transfer, and more. Serving patients across the globe for decades, we continue to serve our patients with safe and quality fertility care.
Contact us today to receive a consultation with a fertility specialist.