Are you doubling over in pain during your period? Do you have cramps you just can’t seem to shake throughout the month? For 1 in 10 women, these killer cramps are a symptom of endometriosis. Although endometriosis affects 190 million women worldwide, many go undiagnosed. March is Endometriosis Awareness Month and the perfect time to educate about this painful, chronic disease. Here’s what you need to know to find out if endometriosis might be affecting you.
What is Endometriosis?
"Endometrial cells are what make up the lining of the uterine cavity," Women's Care of Wisconsin's Dr. Therese Yarroch explains. "In women with endometriosis these cells are found outside of the uterus, where they cause inflammation. Sometimes referred to as 'endometrial implants,' they can be found on the ovaries, fallopian tubes, bladder, bowels and anywhere else in the pelvic region. This inflammation can result in pain and significant scarring to the surrounding tissue."
What Causes Endometriosis?
"We do have evidence that there is an increased risk of endometriosis in women with heavy menstrual bleeding and longer or more frequent menstrual cycles," Yarroch says. "Doctors also know that estrogen plays a role and women who have a close female relative with endometriosis are 5-7 times more likely to have it themselves."
Spotting the Symptoms
"Although it’s a common misconception that endometriosis only occurs in women over the age of 20, the truth is that the disease can develop as soon as a girl gets her first period and can span the rest of a woman’s reproductive years," Yarroch says. "The most common symptom of endometriosis is pelvic pain. While this pain usually coincides with menstruation, some women can experience this symptom throughout their entire cycle.”
Other symptoms to look out for include:
- Pain during or after sex
- Severe cramps that do not go away with NSAIDs or that impede the activities of your everyday life
- A heavy menstrual flow
- Periods that last longer than 7 days
- Nausea or vomiting
- Urinary and bowel disorders
- Difficulty getting pregnant
Not every woman will experience all of these symptoms, but approximately 30%-40% of women who have endometriosis will experience issues with fertility.
Getting a Diagnosis
The only way to know for sure if you have endometriosis is through a surgical procedure called laparoscopy. Laparoscopy uses a small telescope that is inserted into the abdomen through a very small incision. It brings light into the abdomen so the doctor can see inside.
Treating the Symptoms
There are a wide range of treatment options for endometriosis and your doctor may suggest a less invasive methods before ordering a biopsy. Some of the most common treatments include:
- The use of NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve). NSAIDs can help relieve or lessen the pain caused by endometriosis by stopping the release of prostaglandins, one of the main chemicals responsible for painful periods. While NSAIDs can help manage the pain-related symptoms of endometriosis for some women, it’s not effective in every case.
- Birth control methods such as the pill, the patch and the ring are often helpful to treat the pain associated with endometriosis because they reduce heavy bleeding. This method works best for women who only have severe pain during their period and not during the rest of their cycle.
- Progestins are recommended for women who do not get pain relief from or who cannot take hormonal birth control that contains estrogen (such as smokers). This synthetic form of the natural hormone progesterone is available by prescription as a pill or an injection.
- GnRH therapy uses medicines that work by causing temporary menopause. The treatment actually causes the ovaries to stop producing estrogen, which causes the endometriosis implants to shrink.
For some women, surgery may be the best treatment method. While there isn’t a cure for endometriosis yet, it is possible to remove some of the scar tissue and lesions with surgery.
If you have endometriosis, surgery could be an option if you:
- Have severe pain
- Have tried medications, but still have pain
- Have a growth or mass in the pelvic area that needs to be examined
- Are having trouble getting pregnant and endometriosis might be the cause
"It is important to note that there are other conditions that can cause many of the same symptoms as endometriosis," Yarroch says. "An OB/GYN can help determine if endometriosis is the appropriate diagnosis."
So What Now?
"Endometriosis can have a significant impact on a woman's life. Fortunately, there are treatment options available to manage pain and minimize recurrence," Dr. Yarroch says.
