What is endometriosis and how can it be treated?

Endometriosis affects 10% of women worldwide. It is a painful chronic condition where tissue similar to the lining of the uterus, called the endometrium, grows outside the uterus. This misplaced tissue can be found on the ovaries, fallopian tubes, outer surface of the uterus, and other pelvic organs.

During the menstrual cycle, the endometrial tissue outside the uterus still responds to hormonal changes, thickens, and breaks down, leading to inflammation, scarring, and the formation of adhesions (scar tissue) and different endometriotic lesions. The build up of these adhesions can also cause the reproductive organs to begin to stick together. This can cause pain, infertility, and other symptoms associated with endometriosis.

What are the primary symptoms of endometriosis?

Endometriosis has various symptoms, although some individuals may have no symptoms at all. Common symptoms of endometriosis include:

1. Pelvic pain: This is the most common symptom of endometriosis, with pain ranging from mild to severe. The pain may occur before or during menstruation, during intercourse (dyspareunia), or during bowel movements or urination.
2. Menstrual irregularities: Prolonged and painful menstrual periods or irregular menstrual cycles may be experienced.
3. Dysmenorrhea (severe period pain): A large number of patients with endometriosis will experience harsh period pain, known as dysmenorrhea. It is common to have intense abdominal pain, heavy periods, pain during sex, and irregular bleeding. Pain can begin before you begin menstrual bleeding as well as continue through different parts of your cycle.
4. Painful bowel movements or urination: The endometrial-like tissue can affect the bowel or bladder, leading to pain during bowel movements or urination, and sometimes causing diarrhoea, constipation, or blood in the urine.
5. Fatigue: Endometriosis often leaves people feeling excessively tired or experiencing low energy levels, which can be attributed to the hormonal imbalances and chronic pain.
6. Infertility: Some women with endometriosis may experience difficulty conceiving, and might experience recurring miscarriages. While it is still possible to conceive if you have endometriosis, about one third of people do struggle with infertility.
7. Gastrointestinal symptoms: Some individuals may experience bloating, nausea, or digestive issues, especially around the time of menstruation.

How do you treat endometriosis?

While no cure for endometriosis has been found, there are a variety of effective treatments available, such as hormone therapy and surgical procedures, that can improve a person's quality of life. The specific type of treatment for endometriosis may vary depending on factors such as the severity of symptoms, the extent of the disease, and the individual's reproductive goals. Here are some common treatment options for endometriosis:

1. Pain medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help relieve the severe pain associated with endometriosis.
2. Hormone treatments: Hormonal medications, such as birth control pills, progestins, or GnRH agonists, are commonly prescribed to regulate hormone levels, suppress the growth of endometrial tissue, and alleviate symptoms, such as painful periods and a heavy menstrual flow. 
3. Gonadotropin-releasing hormone (GnRH) agonists: Typically used by patients with severe endometriosis, these medications suppress the production of estrogen, inducing a temporary menopause-like state to reduce symptoms and slow down the growth of endometriosis. They are usually prescribed for a limited duration due to potential side effects, including hot flushes (or hot flashes), weight gain, and vaginal dryness. 
4. Progestin therapy: Progestins, which are synthetic forms of the hormone progesterone, can help control the growth of endometrial tissue and manage symptoms. They are available in various forms, including pills, injections, or intrauterine devices (IUDs).
5. Laparoscopic surgery: This minimally invasive surgery is often called a keyhole surgery. It is performed to remove endometrial implants (endometriosis tissue), scar tissue, and cysts caused by endometriosis. It can help alleviate pain and improve fertility in some cases.
6. Hysterectomy: In severe cases or when other treatments have not been effective, a hysterectomy (removal of the uterus) may be recommended. This can provide long-term relief from endometriosis symptoms, but it is typically considered a last resort option, especially for women who still want to have children.

It's important to note that these symptoms are not exclusive to endometriosis and can be indicative of other medical conditions as well. If you suspect you may have endometriosis or are experiencing any of these symptoms, speak with your doctor for a proper evaluation and diagnosis. If you have any further questions about what was discussed in this post, reach out to your Fertifa Patient Advisor who can help answer your questions 💜