What is Endometriosis?
Endometriosis is a condition where the endometrium — cells on the inner layer of the uterus that are shed each month during a woman’s menstrual period — grow in other places, most commonly on the ovaries, the fallopian tubes or the lining of the pelvic cavity.
The condition can cause scarring between the ovaries, fallopian tubes and bowel or pelvic sidewall, making it harder for an egg to reach the uterus from the ovary via the fallopian tube. Endometriosis produces substances that are toxic to the egg, the sperm and the embryo. The endometrial lining inside the uterus also may be not as receptive as it should be due to a hormone receptor imbalance.
All of these factors can make it harder to become pregnant.
Causes and Symptoms
About 6.5 million women between the ages of 15 and 44 are diagnosed with endometriosis. It is especially common in women in their 30s and 40s.
The most likely cause of endometriosis is “retrograde menstruation,” where cells shed during menstruation don’t all exit through the vagina. Some of the tissue gets back into the pelvic cavity through the fallopian tubes.
Retrograde menstruation is usually combined with an underlying autoimmune issue, where cells grow outside the uterus but the body’s immune system does not remove them.
Symptoms may include:
- Pelvic pain
- Painful periods
- Heavy periods
- Problems becoming pregnant
- Or no symptoms at all
Endometriosis can be mild, moderate or severe. The stage of endometriosis usually correlates with the severity of symptoms or difficulty getting pregnant.
Diagnosis and Treatment
Our physicians can usually offer a preliminary diagnosis based on symptoms or a routine pelvic exam. Certain fluid-filled cysts found during an ultrasound could also indicate endometriosis. We can make a definitive diagnosis through a tissue biopsy during laparoscopy, which is a simple outpatient procedure.
Treatment depends on a patient’s goals — to control pain or improve fertility.
Pain can usually be controlled with hormonal medications that stop monthly periods, such as birth control pills taken continuously. We might recommend outpatient surgery to remove the affected tissue in some cases.
Treatments for infertility depend on the stage of endometriosis. If it is mild, stimulating the ovaries along with intrauterine insemination could help patients achieve a successful pregnancy. For more severe cases, the best chance for pregnancy is usually in vitro fertilization.
If you are experiencing pelvic pain or heavy periods, or if you are having trouble getting pregnant, email or call us for a consultation at (502) 897-2144.