Endometriosis

Endometriosis is a common gynecological problem affecting women of reproductive age. It occurs when the tissues of the uterus start growing on surfaces of other organs in the pelvis. Endometrium may grow on ovaries, fallopian tubes, outer surface of uterus, pelvic cavity lining, vagina, cervix, vulva, bladder or rectum. Patients may experience painful cramps in the lower abdomen, back or in the pelvis during menstruation, heavy menstrual bleeding, painful bowel movements or urination and infertility.

The exact cause for the endometriosis is not known, but it is thought to be inherited through genes that run-in families. A defect in the immune system, hormonal imbalance, or as a complication of other surgeries, women may develop endometriosis.

Your gynecologist will ask you about general health, your symptoms and perform a pelvic examination to feel for the presence of large cysts or scars. An ultrasound scan may also be performed to look for ovarian cysts.

There are several treatment options available to minimize the pain as well as control heavy bleeding.

Pain Medication

Over the counter pain relievers may be helpful for mild pain. Prescription strength medications may be prescribed by your doctor in cases of severe pain.

Hormone Treatment

Hormonal preparations can come in a variety of forms and a complete discussion should take place with your provider to decide on the right method for you.

Surgery

Surgery is an option for women having multiple growths, severe pain, or fertility problems.

  • Laparoscopy: During this surgery, growths and scar tissue are removed or burnt. This is a minimally invasive technique and does not harm the healthy tissues around the growth.
  • Laparotomy or major abdominal surgery: This involves a larger cut in the abdomen which allows the doctor to reach and remove the endometrial growth.
  • Hysterectomy: This is a surgery to remove the uterus. The ovaries may or may not also be removed at this time. This procedure is reserved for severe disease in patients who no longer want pregnancy.
  • ACOG
  • AIUM
  • American Association of Gynecologic Laparoscopists
  • NYU langone Medical center
  • American Association for Accreditation of Ambulatory Surgery Facilities
  • UpToDate