Endometriosis Awareness Months

Get the latest scoop on treatments for this painful disorder.

March is Endometriosis Awareness Month throughout the world. Various agencies and organizations try to inform and educate people about what endometriosis is and what help is out there for sufferers of this chronic and often times, painful disease. Endometriosis Association is a self-help organization of patients, healthcare providers, researchers, and advocates who offer information, education, support, and information about research for treatments and possible advances in cures. 

Endometriosis is a medical disorder where endometrial (uterine) tissue grows outside of the uterus and can affect surrounding organs throughout the pelvic area including the ovaries, fallopian tubes, bowels, and tissues lining the pelvic cavity. These endometrial implants can react to the fluctuation of hormones during a woman’s menses and cause irritation, inflammation, and oftentimes pain. Additionally, the implants can cause scar formations and form adhesions that attach to organs that can lead to infertility. 

While the exact cause of endometriosis is not clearly known, there are several theories about possible causes. One is referred to as retrograde menstruation, where it is believed that endometrial cells in menstrual blood flow back into the fallopian tubes and into the pelvis instead of exiting the body. These cells adhere to the pelvic walls and surrounding organs and grow and thicken over each successive period. 

Another theory, called the induction theory, postulates that hormones or immune factors affect peritoneal cells that line the abdomen and transform them into endometrial-like cells. Likewise, the estrogen hormone may play a role in transforming embryonic cells, present from the earliest stage of development, into endometrial-like cells during the onset of puberty. These are just a few hypotheses about what may cause endometriosis, but most involve the presence of hormones, particularly estrogen. 

It’s estimated that approximately 10 percent of women will experience endometriosis with varying symptoms and severity. The most common symptoms of endometriosis are painful periods with cramping and often heavy menstrual bleeding. 

Pain during sexual intercourse is another common symptom. Pain with bowel movements and urination is another accompanying symptom. Like many conditions, symptoms will vary from woman to woman and can fluctuate from month to month. For this reason, there is no one treatment of symptoms that works for every woman. 

Many treatment plans simply involve treating the pain associated with endometriosis to the level of severity. Some women find that over-the-counter pain medications, such as ibuprofen or acetaminophen, offer sufficient pain relief. Moderate to severe pain associated with endometriosis will probably require hormone therapies that can help to mitigate the symptoms, including the use of birth control pills, patches, vaginal rings, or quarterly injections. These hormones reduce the monthly build up of endometrial tissue that can reduce the severity of symptoms. 

Another treatment for more severe cases is injections of leuprolide acetate or Lupron that signals the ovaries to stop making estrogen. This can put the body into a temporary “menopause” with all of the associated side effects, such as hot flashes, mood changes, vaginal dryness, and the like. But for women who suffer from extreme pain, the trade-off may be worth it. A newer medication taken orally called elagolix or brand name Orilissa has shown promising results for the symptoms of endometriosis. 

Surgery to remove endometriosis may be required if symptoms are so severe or fertility is desired. Generally, a gynecologist will perform a laparoscopy to view and remove endometrial implants that are causing pain and impeding pregnancy. 

Successful surgery often results in achieving fertility; however, endometriosis may re-occur after pregnancy. Some women, who do not want to become pregnant or have completed their childbearing may feel that a hysterectomy with the complete removal of their uterus and ovaries is the most appropriate course of action for them. A frank discussion with your healthcare provider is the best way to determine which treatment will work best if you have endometriosis. 

Timothy J. Hardy, M.D.

Dr. Timothy Hardy, M.D. has been practicing medicine in the community for many years. He received his medical degree from Eastern Virginia Medical School and founded his own practice, Atlantic OB-GYN, in 1990, where he has been providing women with exceptional care ever since. Website: www.atlanticobgyn.com
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