Endometriosis

Pelvic pain - endometriosis; Endometrioma

Every month, a woman's ovaries produce hormones that tell the cells lining the uterus to swell and get thicker. Your uterus sheds these cells along with blood and tissue through your vagina when you have your period.

Endometriosis occurs when these cells grow outside the uterus in other parts of your body. This tissue may attach on your:

• Ovaries
• Bowel
• Rectum
• Bladder
• Lining of your pelvic area

It can grow in other areas of the body, too.

These growths stay in your body, they do not shed when you have your period. But, like the cells in your uterus, these growths react to the hormones from your ovaries. They grow and bleed when you get your period. Over time, the growths may add more tissue and blood. The buildup of blood and tissue in your body leads to pain and other symptoms.

No one knows what causes endometriosis. One idea is that when you get your period, the cells may travel backwards through the fallopian tubes into the pelvis. Once there, the cells attach and grow. However, this backward period flow occurs in many women. Researchers think that the immune system in women with endometriosis may cause the condition.

Endometriosis is common. Sometimes, it may run in families. Endometriosis probably starts when a woman begins having periods. However, it usually is not diagnosed until ages 25 to 35.

You are more likely to develop endometriosis if you:

• Have a mother or sister with endometriosis
• Started your period at a young age
• Never had children
• Have frequent periods, or they last 7 or more days
• Have a closed hymen, which blocks the flow of menstrual blood during the period

Pain is the main symptom of endometriosis. You may have:

• Painful periods.
• Pain in your lower belly before and during your period.
• Cramps for a week or 2 before and during your period. Cramps may be steady and range from dull to severe.
• Pain during or following sexual intercourse.
• Pain with bowel movements.
• Pelvic or low back pain that may occur at any time.

You may not have any symptoms. Some women with a lot of tissue in their pelvis have no pain at all, while some women with milder disease have severe pain.

Your health care provider will perform a physical exam, including a pelvic exam. You may have one of these tests to help diagnose the disease:

• Transvaginal ultrasound
• Pelvic laparoscopy

Learning how to manage your symptoms can make it easier to live with endometriosis.

What type of treatment you have depends on:

• Your age
• Severity of your symptoms
• Severity of the disease
• Whether you want children in the future

There are different treatment options.

PAIN RELIEVERS

If you have mild symptoms, you may be able to manage cramping and pain with:

• Exercise and relaxation techniques.
• Over-the-counter pain relievers. These include ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol).
• Prescription painkillers, if needed, for more severe pain.
• Regular exams every 6 to 12 months so your doctor can make sure the disease is not getting worse.

HORMONE THERAPY

These medicines can stop endometriosis from getting worse. They may be given as pills, nasal spray, or shots. Only women who are not trying get pregnant should have this therapy. Hormone therapy will prevent you from getting pregnant. Once you stop therapy, you can get pregnant again.

Birth control pills. With this therapy, you take pills for 6 to 9 months without stopping. Taking these pills relieves most symptoms. However, it does not prevent scarring or treat any damage that has already occurred.

Progesterone pills or injections. This treatment helps shrink growths. However, side effects can include weight gain and depression.