Endometriosis Explained: Signs, Risk Factors and Treatment

In the U.S., more than 11% of women between the ages of 15 and 44 have endometriosis. It’s a condition characterized by endometrial tissue, which typically lines the uterus, growing outside the womb. It can appear on the ovaries, fallopian tubes and even intestines. Women are encouraged to learn the risk factors, signs and treatments associated with this chronic illness.

Cause of Endometriosis: To date, researchers don’t know the exact cause of endometriosis. It can develop in any woman or girl who has a menstrual period. Yet, it’s more prevalent in women in their 30s and 40s.

Risk Factors for Endometriosis: Possible risk factors include genetic ties, a compromised immune system, abnormal menstrual flow and estrogen production. Additionally, abdominal surgery, such as a Cesarean (C-section) or hysterectomy, has been investigated as a potential cause of endometriosis. During some surgical procedures, endometrial tissue can be displaced to the outside of the uterus.

Signs of Endometriosis: Acute pain, particularly in the lower body is the most common sign of endometriosis. More specific symptoms include:

  • Abdominal fullness
  • Aggressive menstrual cramps
  • Bleeding or spotting during periods
  • Digestive problems
  • Infertility
  • Pain during/after sexual intercourse
  • Painful bowel movements
  • Sharp pain in the pelvis or lower back

In some instances, there are no symptoms. A diagnosis isn’t made until the patient is evaluated for a seemingly unrelated health issue.

The Long-Term Effects of Endometriosis: Over time, the outside growths can continue to expand. This may block a woman’s fallopian tubes by covering or spreading to the ovaries. Endometriosis growths can also form scar tissue and adhesions that bind organs together. This could change the shape of the reproductive organs, making it difficult for sperm to find the egg. Researchers have found that 30% to 50% of women with endometriosis are also infertile.

Treatment for Endometriosis: Treatment options can vary by case. Women who have symptoms of endometriosis should talk with a doctor about their individual experience. They will likely conduct a pelvic exam and consider an imaging test like an ultrasound or an MRI. If there are no signs of an ovarian cyst, the doctor can prescribe hormonal birth control to lessen pelvic pain. They may also suggest an intrauterine device (IUD) to reduce pain and bleeding.

Women who are trying to get pregnant may receive a gonadotropin-releasing hormone (GnRH) agonist. It’s a medication that causes them to temporarily enter menopause. When a woman stops taking it, her menstrual period returns with a greater potential for becoming pregnant. Individuals with severe endometriosis may require more invasive treatment like surgery. It’s a joint decision often made by the patient, their gynecologist and a specialist who manages infertility and reproductive endocrinology.

Understanding Endometriosis Prevention: There is no cure for endometriosis, but there are steps women can take to reduce their risk. They can ask a doctor about lowering the level of estrogen in their bodies. This includes using hormonal birth control with less estrogen, exercising regularly to lower body fat and avoiding large amounts of alcohol and caffeinated drinks.

About the Author: Dr. Patricia Ferguson, MD, is a physician consultant at Blue Cross Blue Shield of Michigan. 

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Photo credit: Charday Penn

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