Endometriosis is one the most common gynecological diseases, affecting more than 5.5 million women in North America alone. Endometriosis occurs when the tissue that normally lines the uterus, the endometrium, grows in abnormal locations. This tissue can grow into the muscle wall of the uterus (adenomyosis) or grow on the surfaces of organs in the pelvic or abdominal areas. In rare cases, endometriosis can grow into the lungs or other parts of the body.
The most common symptom caused by endometriosis is pain, mostly in the abdomen, lower back and pelvic area. The pain is commonly noted most severely during the menstrual period and during intercourse. The period may also be very heavy. The amount of pain a woman feels is not linked to how much endometriosis she has.
Sometimes a woman with severe pain will have minimal disease documented in surgery, and a woman without any symptom may unexpectedly have very severe disease found incidentally during surgery. Women with endometriosis are also more likely to have interstitial cystitis (a painful condition involving the urinary bladder) and irritable bowel syndrome; these painful conditions are known to travel in a pack. Endometriosis is also associated with infertility’ it is estimated that 30-40% of women with endometriosis are infertile.
The cause of endometriosis is not clearly understood. It is thought that back flow of a period through the fallopian tubes is a factor. However, most women experience “retrograde menstruation” and most do not develop endometriosis. There is likely a genetic link as endometriosis runs in families. The classic way to diagnose the condition is by laparoscopic surgery. At the time of surgery, implants of endometriosis may be ablated. The most definitive way to treat endometriosis is to perform a hysterectomy with removal of tubes and ovaries; this alleviates all symptoms in 90% of patients. However, there are a number of medications being used that can provide as much relief as laparoscopy.
Please don’t hesitate to discuss any of these symptoms with your doctor so that you can be further evaluated.