Endometriosis is a condition in which tissue from the membrane that normally lines the uterus — the endometrium — grows outside the uterus, typically on the ovaries, fallopian tubes, intestines or other areas in the pelvis. This tissue acts just like the endometrium in accumulating blood in the monthly menses period. but it has no place to shed the blood at the end of the cycle. The accumulation of tissue and blood can cause inflammation and scarring, which can lead to other conditions, particularly pelvic pain and infertility. Blood trapped in the ovaries may develop into benign cysts called endometrioma.
Between 25 and 50 percent of infertile women are estimated to have endometriosis. Endometriosis affects more than one million women in the United States and at this time, the exact cause of the condition is unknown.
Typically, symptoms of endometriosis worsen over time. The severity of symptoms varies, and some women may not experience any symptoms at all. Symptoms may stop after menopause or during pregnancy. though they will return after the woman has the baby and begins menstruating again.
Common symptoms may include:
- Pelvic pain and cramping before and during periods
- Lower back and stomach pain during periods
- Excessive bleeding during periods
- Pelvic pain during intercourse
These symptoms can occur with other conditions. If you’re experiencing any of these symptoms, see your doctor to determine the cause.
In diagnosing endometriosis, your doctor will begin by asking about your symptoms and conducting a physical exam, including a pelvic exam to check for any abnormalities, though these are typically hard to detect without other, more advanced tests.
The tests may include:
- Pelvic exam — This is done to check a woman’s vagina, uterus, bladder and rectum. The doctor feels these organs for any lumps or changes in their shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.
There are several different treatment options available for endometriosis. Your doctor will discuss each treatment in detail and help you determine those that best meet your needs. Treatment may depend on the severity of your condition, your age and whether or not you are planning to have children, and whether you have any other associated conditions.
Hormonal therapies can help slow the growth of endometriosis. These include birth control pills, progestins, Danazol and the newer drugs known as aromatase inhibitors, which act by interrupting local estrogen formation within the endometrial growths.
Over-the-counter pain relievers such as ibuprofen can be taken to manage pelvic pain and menstrual cramping.
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