Endometriosis

What is Endometriosis?

Endometriosis is a chronic condition in which tissue that's similar to endometrium, the tissue that lines the uterus, grows outside the uterus. It can cause pain with periods and sexual activity, irregular bleeding, and potentially impact fertility. Some people with endometriosis do not experience any symptoms.

Endometriosis typically affects organs in the pelvis, such as the ovaries, fallopian tubes, bladder, rectum and tissues lining the pelvis. It can also affect organs and tissues outside the pelvis, such as the bowel or diaphragm. Endometriosis affects approximately 11% of the population.

What Are the Symptoms of Endometriosis?

Some people with endometriosis do not experience any symptoms. For those that have symptoms, the most common symptoms include:

Painful periods (dysmenorrhea)
Pelvic pain and cramping
Pain during sex
Pain with bowel movements or urination
Heavy bleeding during periods (menorrhagia) or between periods (menometrorrhagia)
Infertility
Other symptoms such as fatigue, diarrhea, constipation, bloating, and nausea

Not all pelvic pain is caused by endometriosis. It is important to have an evaluation for other potential causes to determine the best treatment.

What Causes Endometriosis?

The exact cause of endometriosis is not known, but the following factors may play a role:

Retrograde Menstruation: Menstrual blood can flow backward into the pelvic cavity instead of leaving the body.
Embryonic Cell Transformation: Hormones like estrogen can cause certain cells to turn into endometrial tissue during puberty.
Surgical Scar Implantation: Endometrial-like cells can attach to surgical scars from operations like a hysterectomy or C-section.
Immune System Disorders: Problems with the immune system may prevent the body from identifying and removing endometrial-like tissue growing outside the uterus.

UR Medicine's Treatments for Endometriosis

How is Endometriosis Diagnosed?

Diagnosing endometriosis can be challenging. The most definitive diagnosis is biopsies taken at the time of surgery. Imaging can be helpful, but does not see all endometriosis. Your UR Medicine provider may perform:

Pelvic exam
Ultrasound imaging
Magnetic Resonance Imaging (MRI)
Laparoscopy: A surgical procedure where a camera is used to look inside the pelvis

Endometriosis is classified into stages based on the amount of disease and where it is located. An advanced stage diagnosis does not necessarily mean the most severe symptoms—asymptomatic or silent endometriosis can occur at any stage, and severe symptoms may accompany less advanced stages.

How is Endometriosis Treated?

While there is no cure for endometriosis, several treatments can help manage address the problems endometriosis causes:

Medications: Pain relievers like ibuprofen, hormonal treatments including birth control pills, and other hormone-based medications to manage symptoms.
Surgery:
- Fertility-Sparing Surgery: This approach removes as much of the endometriosis as possible while preserving reproductive organs. Treatment may vary depending on the patient's desire for fertility.
- Hysterectomy: While hysterectomy is not a treatment for endometriosis, it may be a part of a treatment plan to address specific symptoms such as bleeding.
Fertility Treatment: Procedures like in vitro fertilization (IVF) may be suggested if endometriosis is making it hard to get pregnant.

It is important to discuss your goals with your provider to determine the best treatment.

Living with Endometriosis

Managing endometriosis involves a combination of treatments and lifestyle changes:

Regular exercise
Dietary changes
Stress management, like yoga and meditation
Support groups and counseling for emotional support

What Sets Us Apart?

UR Medicine Obstetrics and Gynecology is made up of women’s health experts who actively engage in everything that supports women's health, including patient care, research, and education.

Our team includes fellowship-trained minimally invasive gynecologic surgeons who specialize in evaluation and management of endometriosis, chronic pelvic pain syndromes, and advanced gynecologic surgery. Our surgeons collaborate with other surgical subspecialties to optimize management of complex endometriosis, including bowel, bladder, diaphragm and chest disease.

Our Reproductive Endocrinology and Infertility team works in close collaboration with our surgical team in addressing endometriosis-related infertility.