Endometriosis is an often painful condition in which tissue that is similar to the inner lining of the uterus grows outside the uterus. It often affects the ovaries, fallopian tubes, and the tissue lining the pelvis. Rarely, endometriosis growths may be found beyond the area where pelvic organs are located.
Endometriosis tissue acts as the lining inside the uterus, it thickens, breaks down, and bleeds with each menstrual cycle. But it grows in places where it doesn’t belong, and it doesn’t leave the body. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated and form scar tissue. Bands of fibrous tissue called adhesions also may form. These can cause pelvic tissues and organs to stick to each other.
The main symptom of endometriosis is pelvic pain. This pain can be intense or mild. Symptoms often feel worse just before and during your period due to inflammation brought on by the hormonal changes that occur at the time. Other symptoms of endometriosis include:
- Excruciating menstrual cramps
- Abdominal pain or back pain during your period or in between periods
- Heavy bleeding during periods, or spotting between periods
- Pain during sex
- Infertility
- Pain when pooping or peeing
- Stomach problems like diarrhea, constipation, or bloating
You can have no symptoms of endometriosis. The seriousness of your pain may not be a sign of the number or extent of endometriosis growth in your body. You could have a small amount of tissue with bad pain. Or you could have little to no pain and have lots of endometriosis tissue. Women often find out they have the condition when they can’t get pregnant or after they have an unrelated surgery.
The exact cause of endometriosis isn’t clear. But some possible causes include:
- Retrograde menstruation
- Transformed peritoneal cells
- Embryonic cell changes
- Surgical scar complication
- Endometrial cell transport
- Immune system condition
Factors that raise the risk of endometriosis include:
- Never giving birth
- Starting your period at an early age
- Going through menopause at an older age
- Short menstrual cycles (less than 27 days)
- Heavy menstrual periods that last longer than seven days
- Having higher levels of estrogen in your body or greater lifetime exposure to estrogen your body produces
- Low body mass index
- One or more relatives with endometriosis, such as a mother, aunt, or sister
Any health condition that prevents blood from flowing out of the body during menstrual periods also can be a risk factor for endometriosis. So can conditions of the reproductive tract.
To diagnose endometriosis, your doctor will likely start by giving you a physical exam. You’ll be asked to describe your symptoms, including where and when you feel pain. Tests to check for clues of endometriosis include
- A pelvic exam
- Ultrasound
- MRI
- Laparoscopy
Treatment for endometriosis often involves medicine or surgery. The approach you and your healthcare team choose will depend on how serious your symptoms are and whether you hope to become pregnant. Medicine is typically recommended first. If it doesn’t help enough, surgery becomes an option. Treatments for endometriosis include:
- Pain medicines
- Hormone therapy
- Fertility treatment
- Conservative therapy
- Hysterectomy with removal of the ovaries
At Jamaica Hospital’s Department of Women’s Health Services, we are passionate about meeting the various needs of women in our community. We proudly treat women from all walks of life and provide a warm and welcoming environment. To learn more about our OB/GYN services or to make an appointment, contact us at 718-291-3276.
