Endometriosis: A Common Cause Of Debilitating Pelvic Pain

What Is Endometriosis?

chronic pelvic pain

The endometrium is the layer of tissue that covers the inside of the uterus. Endometriosis is a common condition in which the endometrium begins to grow outside of the uterus, usually on the ovaries or fallopian tubes. In rare, severe cases, endometrial tissue may even grow in other parts of the body, such as the lungs and brain. It is most commonly seen in women aged 30 to 40, but is occasionally seen in women during young adulthood. It is estimated that 10.8 million women around the world have endometriosis.

Causes

The exact cause of endometriosis is unknown, but some research shows it may be in an individual’s genetics. There may also be a link between immune system disorders and developing endometriosis.

pelvic pain

Types

There are three types of endometriosis.

Superficial Endometriosis

This type of endometriosis is characterized by its small endometrial lesions. The lesions do not have much mass and usually only grow to be 1 to 2 cm wide.

Deep Infiltrating Endometriosis

This type of endometriosis is typically considered the most painful. In deep infiltrating endometriosis, endometrial lesions penetrate the bowel, bladder and vagina more than 5mm deep. These lesions can even penetrate the surrounding nerves, causing severe pain.

Ovarian Endometriotic Cysts

This type of endometriosis refers to large fluid-filled cysts that grow on or around the ovaries. They usually grow to around 3 to 4 cm, but can grow as large as 15 cm in rare cases.

endometriosis signs

Symptoms

  • Pelvic pain
  • Severe cramps during menstruation
  • Pain during intercourse
  • Pain during urination or bowel movements
  • Infertility
  • Lower abdominal pain
  • Diarrhea
  • Constipation
  • Lower back pain
  • Irregular menstrual cycle
  • Heavy menstrual flow
  • Chronic fatigue
  • Chest pain
  • Headache

Diagnosis

diagnosing endometriosis

Laparoscopy is one way to diagnose endometriosis.

There are several ways to diagnose endometriosis. Some cases can be diagnosed by a pelvic exam, in which your gynecologist examines your vulva, uterus, ovaries and cervix. If endometrial lesions cannot be palpated during a pelvic exam, diagnostic imaging like ultrasounds and CT (computer tomography) scans can reveal lesions. Laparoscopy is also frequently used to diagnose endometriosis. A laparoscopy is a surgical procedure in which a fiber-optic instrument is actually inserted through the abdominal wall and used to visualize the anatomy of the abdomen and pelvic region.

Treatment

Conservative treatment of endometriosis consists of hormone therapy. Hormones such as progesterone can inhibit the growth of endometrial tissue. Painkillers can be prescribed to control the severe pelvic pain associated with endometriosis. In moderate cases, the endometriosis can actually be extracted in a surgical procedure, though it often grows back. For women who do not wish to conceive, they may choose to treat their endometriosis by having their uterus removed in a hysterectomy.

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