Endometriosis (say “en-doh-mee-tree-OH-sus”) is a problem many women have during their childbearing years. It means that a type of tissue that lines your uterus is also growing outside your uterus. This does not always cause symptoms. And it usually isn’t dangerous. But it can cause pain and other problems.
The areas of tissue that grow outside your uterus are called endometriotic foci. They usually grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases, they spread to areas beyond the belly.
Endometriosis, sometimes called “endo,” is a common health problem in women. It gets its name from the word endometrium, the tissue that normally lines the uterus or womb. Endometriosis happens when this tissue grows outside of your uterus and on other areas in your body where it doesn’t belong.
Most often, endometriosis is found on the:
- Fallopian tubes
- Tissues that hold the uterus in place
- Outer surface of the uterus
- Other sites for growths can include the vagina, cervix, vulva, bowel, bladder, or rectum.
- Rarely, endometriosis appears in other parts of the body, such as the lungs, brain, and skin.
Some women with endometriosis don’t have symptoms. Other women have symptoms that range from mild to severe. Symptoms may include:
– Pelvic pain.
– Severe menstrual cramps.
– Low backache 1 or 2 days before the start of the menstrual period (or earlier).
– Pain during sexual intercourse.
– Pain during bowel movements.
– Nausea and vomiting.
This may be the only sign that you have endometriosis. Between 20% and 40% of women who are infertile have endometriosis
– Blood in the urine or stool.
– Some vaginal bleeding before the start of the menstrual period.
– Vaginal bleeding after sex
There is no cure for endometriosis, but treatment can help with pain and infertility. Treatment depends on how severe your symptoms are and whether you want to get pregnant. If you have pain only, hormone therapy to lower your body’s estrogen levels will shrink the lesions/growths and may reduce pain. If you want to become pregnant, having surgery, infertility treatment, or both may help.
Not all women with endometriosis have pain. And endometriosis doesn’t always get worse over time. During pregnancy, it usually improves, as it does after menopause. If you have mild pain, have no plans for a future pregnancy, or are near menopause (around age 50), you may not feel a need for treatment. The decision is up to you.
If you have pain or bleeding but are not planning to get pregnant soon, birth control hormones (patch, pills, or ring) or anti-inflammatories (NSAIDs) may be all that you need to control pain. Birth control hormones are likely to keep endometriosis from getting worse. If you have severe symptoms or if birth control hormones and NSAIDs don’t work, you may try a stronger hormone therapy
Besides medicine, you can try other things at home to help with the pain. For example, you can apply hot water bag to your belly, or you can exercise regularly.
If hormone therapy doesn’t work or if growths are affecting other organs, surgery is the next step. It removes endometrial growths and scar tissue. This can usually be done through one or more small incisions, using laparoscopy. Laparoscopy can reduce pain and improve your chance for pregnancy.
In severe cases, removing the uterus and ovaries (hysterectomy and oophorectomy) is an option. This surgery causes early menopause. It is only used when you have no pregnancy plans and have had little relief from other treatments.
If you are having trouble becoming pregnant even after surgery, you can consider trying fertility drugs with insemination or in vitro fertilization. To learn more, see the topic Fertility Problems.
You can’t prevent endometriosis. But you can reduce your chances of developing it by lowering the levels of the hormone estrogen in your body. Estrogen helps to thicken the lining of your uterus during your menstrual cycle. To keep lower estrogen levels in your body, you can:
Talk to your doctor about hormonal birth control methods
Examples: Pills, patches or rings with lower doses of estrogen.
Exercise regularly (more than 4 hours a week)
This will also help you keep a low percentage of body fat.Regular exercise and a lower amount of body fat help decrease the amount of estrogen circulating through the body.
Avoid large amounts of alcohol
Alcohol raises estrogen levels. No more than one drink per day is recommended for women who choose to drink alcohol.
Avoid a large number of drinks with caffeine
Studies show that drinking more than one caffeinated drink a day, especially sodas and green tea, can raise estrogen levels.
RISKS – IF LEFT UNTREATED
Several factors place you at greater risk of developing endometriosis, such as:
- Never given birth
- Starting your period at an early age
- Going through menopause at an older age
- Short menstrual cycles — for instance, less than 27 days
- Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
- Low body mass index
- Alcohol consumption
- One or more relatives (mother, aunt or sister) with endometriosis
- Any medical condition that prevents the normal passage of menstrual flow out of the body
- Uterine abnormalities
- Endometriosis usually develops several years after the onset of menstruation (menarche).
- Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you’re taking estrogen.