What is endometriosis?Endometrial tissue lines the uterus. Each month, in tune with the menstrual cycle, the endometrial tissue thickens and is shed during menstruation.
If you have endometriosis, it means that the same kind of tissue that lines your uterus is also growing in other parts of your body, usually in the abdomen. This can cause scar tissue to build up around your organs.
Endometriosis may cause severe pain and abnormal bleeding, usually around the time of your period. Pain during intercourse is another common symptom. However, it is possible to have endometriosis and not have any symptoms. Endometriosis is a leading cause of infertility(inability to get pregnant). Often it is not diagnosed until a woman has trouble getting pregnant.
Endometriosis will lessen after menopause and during pregnancy, since the growth of endometrial tissue depends on estrogen. If you have endometriosis and take estrogen-replacement therapy after menopause, the tissue may grow back.
The only way to be sure that you have endometriosis is through a surgical procedure, laparoscopy. Endometriosis can be a chronic condition and may return even after treatment with medicine or surgery.
How can endometriosis be treated?There are several options for treating endometriosis. The best treatment for you may depend on whether you want to relieve pain, increase your chances of getting pregnant, or both. It is important to work with your doctor to weigh the benefits and risks of each treatment.
Nonsurgical treatments include:
- Medicine, including hormones. There are two types of hormone therapy: those that will make your body think it is pregnant and those that will make your body think it is in menopause. Both are meant to stop the body from producing the messages that cause the endometrial tissue to grow. Birth control pills may be used for a few months to try to shrink the adhesions in women who want to become pregnant. Other hormones-GnRH and danazol-also may help relieve the pain of endometriosis.
- Doctors sometimes prescribe pain relievers, such as ibuprofen (for example, Advil and Motrin) or, for severe pain, codeine.
- Other nonsurgical options include watchful waiting and changes in diet and exercise.
Several types of surgery are used to treat endometriosis, including:
- Laser laparoscopy, in which a cut is made in the abdomen and adhesions are removed, either by laser beams or electric cauterization.
- Hysterectomy, which may not cure endometriosis. Unless the ovaries are removed also, they will continue to produce estrogen. This may encourage endometrial tissue to grow in other areas of the body.
- Bowel resection, which means taking out a section of the bowel, if endometriosis is affecting the bowel.
- Cutting certain nerves, called the sacral nerves, in the lower back to relieve pain.
Reprinted from the Agency for Health Care Policy and Research (AHCPR)