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Why is My Period So Painful?

Common Symptoms of Endometriosis and When It’s Time to Talk to Your Gynecologist
By Michelle Winter, MD

Endometriosis is a common condition that impacts up to one in every ten women in the United States. Endometriosis develops when the tissue lining your uterus, called your endometrium, grows outside of your uterus, most commonly in your ovaries, fallopian tubes and/or peritoneum. These abnormal tissue growths are called implants and although not as common, they can also develop in areas outside of your pelvic organs.

As endometriosis progresses, it can affect your body in a variety of ways. Implants may grow and can bleed each month during your menstrual cycle, which may cause the surrounding tissue to become inflamed or irritated. As the implants break down each month, scar tissue can form and cause pain before and/or during your menstrual cycle.

Symptoms

Pelvic pain, often just before and during your menstrual period, is the most common symptom of endometriosis. You may experience no pain, but still have significant scar tissue growth from multiple implants, while other women may experience more pain with less implants and scarring. Other common symptoms include pain during sexual intercourse, urinary symptoms, bladder pain, generalized or local pelvic pain and pain during bowel movements.

Diagnosis and Treatment

At the onset of your symptoms, a pelvic exam may be performed, and is sometimes followed by a laparoscopy to diagnose the condition. The laparoscopy allows your doctor to confirm the diagnosis and determine the severity of your endometriosis based on the amount of endometrial tissue found outside of your uterus. During the procedure, a thin instrument (laparoscope) is inserted though a small incision in your abdomen to allow your doctor to view your pelvic area. In some cases, a small amount of tissue may be taken for additional testing.

Your doctor will consider several factors when developing your treatment plan including the severity and symptoms of your endometriosis, and whether or not you want to have children in the future. Treatment options may include medication, surgery or both.

Medication Treatment

Medications to treat endometriosis include pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs) and hormonal treatments. The hormonal treatments include oral pills, injectable medications and intrauterine devices. Although medications will not remove endometriosis tissue, hormone therapy slows the growth of new tissue.

Surgical Treatment

Surgery is often used to remove implants and provide symptom relief. In some cases, when only a portion of the endometriosis tissue can be removed, your symptoms may still be present. After surgery, you may be prescribed medications to lessen your pain and slow the growth of new endometriosis. If you’re experiencing severe endometriosis with significant, chronic pain, a hysterectomy may be recommended.

Risk Factors

Endometriosis is not preventable. Beginning menstruation at a young age, entering menopause later in life and low body mass index (BMI) can increase your risk of developing endometriosis. Endometriosis also tends to run in families and is more common in Caucasian and Asian women.

Complications

Many women who experience fertility issues are subsequently found to have endometriosis. It is important to know that while fertility issues are a common complication associated with endometriosis, many women do not experience any difficulty becoming pregnant. Your fertility may be impacted if the inflammation associated with your endometriosis damages the fallopian tubes and thus restricts the movement of sperm or eggs.

If you’re experiencing any symptoms associated with endometriosis, consult with your gynecologist. Although there is no cure for the condition, early diagnosis can help you manage your symptoms and slow the growth of implants. Schedule an appointment with a DuPage Medical Group gynecologist.

 

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Obstetrics and Gynecology
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