Endometriosis 101


If you have endometriosis, you are not alone. This painful, chronic condition affects as many as 6.3 million women in the U.S. and millions more worldwide, according to the Endometriosis Association. Although birth control medications can help to lessen the symptoms, they are not always the answer—especially if you are trying to get pregnant.

Written by Wayne Friedman, M.D. on behalf of Tennova Healthcare.

Here are some facts about endometriosis, including what you can do to slow its progression:

What is endometriosis?

Endometriosis occurs when tissue that normally lines the uterus grows in other areas of the body, usually in the abdomen and on the ovaries, bowel and bladder. When endometriosis involves the ovaries, cysts may form.

The cause of endometriosis is still unknown, although it often runs in families. In addition to genetics, scientists suspect there may be structural, biochemical or immunological factors that may predispose women to the disease. However, it is unclear if these factors contribute to endometriosis or simply result from it.

What are the symptoms?

The disease can cause severe pelvic pain, bleeding, formation of scar tissue, and other medical problems including infertility. Endometriosis can go undiagnosed for many years because it mimics other health conditions that cause abdominal pain, such as pelvic inflammatory disease or irritable bowel syndrome.

Endometriosis symptoms include:

  • Pelvic pain and cramping, which may begin before and extend several days into a woman’s menstrual period
  • Pain with intercourse
  • Pain with bowel movements or urination, typically during menstrual periods
  • Diarrhea, constipation, bloating or nausea, especially during periods
  • Excessive bleeding during periods or bleeding between periods

Does endometriosis cause infertility?

It is estimated that up to 50 percent of women with endometriosis will experience infertility. Endometriosis can make it more difficult to get pregnant due to:

  • Scarring in the fallopian tubes
  • Cysts or adhesions in the ovaries
  • Inflammation in the pelvic structure
  • Changes in the hormonal environment of the eggs

How is it diagnosed?

Endometriosis cannot be confirmed with routine gynecological exams. A diagnosis is considered uncertain until proven by laparoscopy, a minimally invasive procedure done under anesthesia. It can show the location, size and extent of any growths. The outpatient procedure helps to determine the optimal plan of treatment.

How is endometriosis treated?

Although there is no cure for endometriosis, pelvic pain can be relieved by birth control hormones (pills, patches, rings, injections, etc.) or anti-inflammatories (NSAIDS). If you have severe symptoms, or if birth control hormones and NSAIDs don’t work, you might need stronger hormone therapy.

Besides medicine, you can try other things like heat to the belly, exercise or massage therapy. Diet and other lifestyle changes have been reported to help treat endometriosis, but there is little scientific evidence to support this.

Women whose symptoms continue—despite the pill or other hormone suppressants—should consider laparoscopic surgery for a full diagnosis and treatment. Surgical treatment of endometriosis has been shown to relieve pain and also improve fertility, especially among women with mild endometriosis who hope to get pregnant within a year because abnormal tissue may grow back to some extent. Your doctor may also recommend certain medical treatments following surgery, especially if endometriosis is diagnosed. These could include stronger hormonal therapies, such as Lupron Depot.

If you suspect you have endometriosis, talk to your doctor. Receiving an early and accurate diagnosis provides the best opportunity to slow the progression of the disease, which allows women and girls to engage in normal everyday activities.

Need an OB/GYN? For a referral to a women’s care specialist, call 1-855-TENNOVA (836-6682) or visit TennovaMedicalGroup.com.

About the Author: 

Dr. Wayne Friedman is a board-certified obstetrician and gynecologist with Tennova Women’s Care in Knoxville, LaFollette and Lenoir City. He specializes in a full range of women’s health services. Dr. Friedman delivers babies at Physicians Regional Medical Center in Knoxville. He also performs gynecologic surgery at both Physicians Regional Medical Center and Turkey Creek Medical Center in West Knoxville.



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