Endometriosis is the leading cause of infertility in women.

Many women with endometriosis have chronic pain in the pelvic area (the lower part of the trunk of the body). The pain is often a severe cramping that occurs on both sides of the pelvis, radiating to the lower back and rectal area and even down the legs. The pain may be continuous or it may come and go. Pain tends to worsen over time.

Pain symptoms in the following cases can be indicative of endometriosis:

• Painful periods.
• Pain in the lower abdomen before and during menstruation.
• Cramps for a week or two before menstruation and during menstruation; cramps may be steady and range from dull to severe).
• Pain during or following sexual intercourse.
• Pain with bowel movements.
• Pelvic or low back pain that may occur at any time during the menstrual cycle.

There may be no symptoms. Some women with a large number of tissue implants in their pelvis have no pain at all, while some women with milder disease have severe pain.

Treatment depends on the following factors:

• Age
• Severity of symptoms
• Severity of disease
• Whether you want children in the future

If you have mild symptoms and do not ever want children, you may choose to have regular exams every 6 – 12 months so the doctor can make sure the disease isn’t getting worse. You can manage your symptoms by using:

Exercise and relaxation techniques
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), acetaminophen (Tylenol), or prescription painkillers to relieve cramping and pain.

For other women, treatment options include:
Medications to control pain
Hormone medications to stop the endometriosis from getting worse
Surgery to remove the areas of endometriosis or the entire uterus and ovaries

Treatment of endometriosis

Hormonal Treatments

• Progesterone pills or injections. However, side effects can be bothersome and include weight gain and depression.
• Gonadotropin-agonist medications such as nafarelin acetate (Synarel) and Depo Lupron to stop the ovaries from producing estrogen and produce a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment is usually limited to 6 months because it can lead to bone density loss. It may be extended up to 1 year in some cases.

Surgery

• Pelvic laparoscopy or laparotomy to diagnose endometriosis and remove all endometrial implants and scar tissue (adhesions).
• Hysterectomy to remove the womb (uterus) if you have severe symptoms and do not want to have children in the future. One or both ovaries and fallopian tubes may also be removed. If you do not have both of ovaries removed at the time of hysterectomy, your symptoms may return.

Please watch the following video for more information on causes, symptoms, and treatements.

Posted by Fertility Portland on
Categories: Biopsies, Endometriosis, Infertility, Ovarian Cysts