Do you suffer from painful periods? Experience discomfort during sexual intercourse? Feel intense pressure and pain when you have a bowel movement? You could have a condition called endometriosis.
"Endometriosis happens when the tissue that lines the inside of the uterus, called the endometrium, lands outside of the uterus," says Page Animadu, M.D., an obstetrician/gynecologist at Henry Ford Health.
What Is Endometriosis?
While endometriosis typically occurs in the lower abdomen or pelvis, it can show up almost anywhere in your body.
"The endometrial tissue can leave the uterus and travel to different parts of the body, including the pelvis, stomach, colon, even the lungs," Dr. Animadu says. Once it lands outside the uterus, it's called an endometrial implant.
Key symptoms of endometriosis include:
- Pelvic or lower abdominal pain
- Painful periods
- Pain with sexual intercourse
- Pain during bowel movements
What makes endometriosis even more confusing is that symptoms are not an indication of disease severity. You can have only slight discomfort with extensive disease and debilitating pain with only mild disease. Some women don't have any symptoms at all.
What Causes Endometriosis?
Doctors aren't clear what causes endometriosis, but they do have a few theories:
- Retrograde menstruation. Instead of the uterine lining shedding down and out through the vagina, it flows backward, up through the fallopian tubes and into the pelvis. From there, the tissue can land anywhere.
- Coelomic metaplasia. Cells in the body outside of the uterus change into the same cells that line the uterus.
- Migrating uterine cells. Cells from the uterine lining travel through the blood vessels and lymphatic system to distant organs and body areas.
Who Is At Risk Of Developing Endometriosis?
Ovulation is the triggering factor for endometriosis. If you don't ovulate, your body won't get the message to build up the uterine lining.
"Women who start their periods earlier and those who enter menopause later have a higher risk of developing endometriosis," Dr. Animadu says. "Genetics may play a role, particularly when you consider that onset of menstruation and menopause may be influenced by genetics."
Body weight can also be a factor since the lining of the uterus is thicker among overweight women.
How Can Endometriosis Be Managed?
While there's no cure for endometriosis, there are things you can do to help alleviate disruptive symptoms. Options include:
1. Clean up your diet. Certain foods encourage the proliferation of the uterine lining, so cleaning up your diet may help improve endometriosis. "Reducing processed foods, cutting down on saturated and trans fats, and restricting alcohol and caffeine can make a world of difference for women who have endometriosis," Dr. Animadu says.
2. Consider birth control pills. With endometriosis, the goal is to stop the growth of the uterine lining. One way to do that is with birth control pills. Contraception without estrogen, whether through oral pills or an intrauterine device (IUD), can help prevent the endometrium from growing.
3. Talk to your doctor. If lifestyle strategies and birth control don't improve symptoms, doctors have a few alternatives to help women who have endometriosis:
- Medication: In addition to birth control pills, there are a variety of medications that may help ease symptoms for women who have endometriosis. One in particular, gonadotropin-releasing hormone, or GnRH, can help nudge women into a temporary menopause-like state.
- Ablation: With ablation, doctors burn the uterine lining deposits outside of the uterus using minimally invasive tools.
- Surgery: Doctors use surgery to diagnose and treat endometriosis. Doctors can remove scar tissue and reposition the ovaries and fallopian tubes. "Unfortunately, surgery isn't a cure," Dr. Animadu says. "Endometriosis can come back." Women who have completed their families and opt for a total hysterectomy, which removes the uterus, ovaries and fallopian tubes, have the greatest chance of success.
"If you're suffering from painful periods, uncomfortable sex or lower abdominal pain and pressure, ask your doctor to do a workup for endometriosis," Dr. Animadu says. "Since endometriosis can interfere with your ability to become pregnant, it's important to talk to your doctor about the best ways to manage it — both before and after you start your family."
If birth control isn't helping symptoms and you're planning on having children someday, doctors may suggest women try to get pregnant sooner rather than later. "Pregnancy often improves endometriosis," Dr. Animadu says. Once you've finished building your family, you can get surgical treatments to help alleviate endometriosis.
To find a doctor or certified nurse midwife at Henry Ford, visit henryford.com or call 1-800-436-7936.
Dr. Page Animadu is an obstetrician and gynecologist who sees patients at Henry Ford Medical Center - Detroit Northwest.
