Endometriosis

Endometriosis is a condition that can cause sometimes severe pelvic pain,  painful periods, and pain during intercourse.

 

It can also be responsible for infertility. 

If you believe you are experiencing symptoms of or are suffering from endometriosis, or if you simply have questions about endometriosis, we encourage you to contact our office.

Endometriosis Facts:

Endometriosis occurs in about 1 in 10 women of reproductive age.

  • It is most often diagnosed in women in their 30s and 40s.
  • About 40% of women who have difficulty getting pregnant suffer from endometriosis. 
  • In the United States, it takes on average 11 years before a woman is correctly diagnosed.

Women are at higher risk for endometriosis if they:

  • Have a mother, sister, or daughter with endometriosis.
  • Started their periods at an early age (before age 11).
  • Have short monthly cycles (less than 27 days).
  • Have heavy menstrual periods that last more than 7 days.
  • Have lean body mass or low body fat.

Factors that may lower the risk for endometriosis include:

  • Pregnancy.
  • Periods that start later in adolescence.
  • Breast feeding.
  • Maintaining a weight that’s healthy for you.

How does endometriosis happen?

The endometrium is the inner lining of your uterus. Think of the endometrium as layers of tissue that build up along the inside lining of your uterus. 

During the menstrual cycle, the endometrium responds to hormones by thickening with blood vessels in preparation for pregnancy. Every time the egg fails to be fertilized, the body clears away the unused endometrial tissue lining the uterus. 

 

When you have a period, these layers fall away from the walls of your uterus and leave your body

 

This tissue is what you shed during a menstrual period.

Menstrual flow

Retrograde Menstrual Flow

The theory of retrograde menstruation is  proposed as the cause of endometriosis:

Endometrial cells flow backward through the fallopian tubes and into the pelvis during menstruation instead of through the vagina and out your body. 

Endometrial cells that enter the abdomen this way can implant on the surface of the organs in your pelvis. 

With endometriosis, implants of endometrial tissue are found within the peritoneum, which lines the pelvis covering the outer surface of the uterus, bladder, intestine, and rectum. 

The cul-de-sac, which is the space behind the uterus, is the lowest point of the pelvis and one of the most commonly affected areas.

Endometriosis can also implant on the surface of and within the ovaries.

What then happens…

Endometriosis tissue responds to changes in a hormone called estrogen.

The implants of endometrial tissue may grow and bleed like the endometrium lining of the uterus during the menstrual cycle. When this happens, the blood and tissue shed from the endometriosis implants into the surrounding tissue, which become irritated, inflamed, and swollen.

The bleeding, inflammation, and scarring can cause pain, especially before and during menstruation.

Symptoms

The severity of the pain does not correspond with the number, location, or extent of endometriosis lesions. Some women with only a few small lesions experience severe pain; other women may have very large patches of endometriosis but experience little pain. Symptoms may include:

  • Painful, debilitating menstrual cramps before and during your period.
  • Adominal bloating or periodic bloating.
  • Painful intercourse.
  • Diarrhea or constipation that occurs cyclically.
  • Painful bowel movements during your menstrual period.
  • Urinary urgency or frequency that occurs cyclically.
  • Painful urination during your menstrual period.
  • Lower back pain.
  • Premenstrual spotting or bleeding between periods.
  • Infertility.

The providers at County Obstetrics & Gynecology are experienced in minimally invasive surgery.

The only way to accurately diagnose endometriosis is through an outpatient surgical procedure call laparoscopy:

To remove the endometriosis, the surgeon makes at least one to two more small incisions in the lower abdomen, and inserts lasers or other surgical instruments to vaporize and remove endometriosis implants.

After making a small incision in the abdomen, usually at the umbilicus (belly button), the surgeon uses a small viewing instrument with a light, called a laparoscope, to look at the reproductive organs, intestines, and other surfaces to see if there is any endometriosis.

If you believe you are experiencing symptoms of or suffering from, endometriosis or if you simply have questions about endometriosis, we encourage you to contact our office.

We have the knowledge, experience, and resources to identify the cause of your pain.

We will then discuss available treatment options and assists you in selecting a treatment plan that best meets your needs.

Treatment is tailored to each individual woman, depending on her age, overall health, and severity of symptoms and future fertility plans.