Endometriosis is one of the most common gynecological diseases affecting approximately 6.5 million women nationwide. Endometriosis ranks third among the nation’s leading causes of gynecologic hospitalization. It is very common, affecting about one in ten women.
March is National Endometriosis Awareness Month. MetroWest Medical Center Women’s Health Services outlines the most frequently asked questions about this female condition.
What is Endometriosis?
Endometriosis is a condition where tissue grows outside the uterine cavity, such as the ovaries or fallopian tubes. It is normal tissue, not a cancer, but it can still cause great discomfort and other medical problems.
What are the symptoms?
Endometriosis can cause a wide range of symptoms depending on where the lesions grow. The main symptoms include significant pelvic pain, often during menstruation, which can interfere with daily life. Aside from severe cramping, women may also experience pain during intercourse, pain associated with bowel movements or urination, and very heavy periods.
Endometriosis can affect any woman who has monthly periods, but is most often diagnosed in women that are in their 30’s or 40’s. It’s more likely to develop in women who:
- Have not had a child
- Have very heavy periods
- Periods that last longer than 7 days
- Have short menstrual cycles (less than 27 days)
- Have a mother, sister daughter with Endometriosis
- Began their periods early (before age 11)
How does it affect a woman’s body?
Just like the lining of the uterus, endometrial tissue outside the uterus responds to a woman’s hormones by growing thicker and then bleeding each month. This irritates the surrounding tissues in the pelvis. Scar tissue can develop, causing organs in the pelvis to become stuck together. The inflammation and scarring causes pain especially before and during a menstrual cycle.
The lesions can affect infertility. Various studies estimate that 30 to 50% of women with Endometriosis have difficulty getting pregnant. The causes of infertility are complex, so determining if Endometriosis is affecting pregnancy is difficult to determine. Endometrial tissue and the adhesions they produce can interfere with the path of an egg from the ovary to the fallopian tube and onward to fertilization. Inflammation in the pelvis causes other changes that may also reduce infertility.
How does your OB/GYN determine whether you have Endometriosis?
A discussion with your OB/GYN physician and a pelvic exam will start the process. A surgical, minimally invasive procedure called laparoscopy, is the only sure way to diagnose Endometriosis which looks for misplaced uterine tissue inside the pelvis. Laparoscopy is recommended only if conservative treatment like medication does not manage the menstrual pain.
What treatments can help?
While there is no cure for Endometriosis, treatments like pain relievers, hormone therapy and surgery can help. Depending upon the severity of symptoms, and if pregnancy is to be considered in the future, recommendations will vary. Medications like ibuprofen can relieve mild to moderate pain. Hormonal medications, primarily birth control pills, can be used to treat Endometriosis. These medications help suppress the growth of endometrial tissue and may ease symptoms.
Surgery may be considered for women experiencing infertility when conservative treatments are not sufficient. Using robotic surgery or laparoscopy, areas of misplaced endometrial tissue can be removed. Endometriosis can return, so a medication to suppress the ovary function may be considered for six months. Your OB/GYN may recommend a hysterectomy (surgery to remove the uterus) for severe Endometriosis to remove as much endometrial tissue as possible. Removing the ovaries does reduce the chance that Endometriosis will return.
What to do if you suffer from these symptoms?
If you or someone you know experiences these symptoms, please seek medical help, especially if planning for a pregnancy. Our OB/GYN team at MetroWest Medical Center can help evaluate your symptoms. Many options exist to help women with Endometriosis achieve a successful pregnancy. Your OB/GYN and an infertility specialist can help choose a treatment plan based on individual situation, age and severity of Endometriosis. Early treatment can help improve quality of life.
To learn more about Endometriosis or to schedule an appointment with our OB/GYN team visit here.
About MetroWest Medical Center
MetroWest Medical Center is a teaching community health care system serving the greater MetroWest region of Massachusetts. For more than 125 years, it provides services in three locations: Framingham Union Hospital, a full-service acute care hospital in Framingham; Leonard Morse Hospital, a behavioral health facility in Natick; and MetroWest Wellness Center, an outpatient care center of MetroWest Medical Center in Framingham. MetroWest Medical Center is committed to meeting the health care needs of the area residents by providing advanced medicine and personalized care, right in the local community. In 2023, Healthgrades® named MetroWest Medical Center one of America’s 100 Best Hospitals for Coronary Intervention Award™, which puts MetroWest Medical Center in the top 5% of hospitals nationwide for Coronary Intervention. To learn more, visit www.mwmc.com.
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