Endometriosis
Endometriosis is a condition that is often under diagnosed and occurs in women when tissue that should be in the inner uterus lining exists outside of the uterus, often behind the uterus, on the bowels, or on the bladder or even in the upper abdomen or lungs. Endometriosis is most commonly diagnosed among women in their 20s and 30s but can also show up in the teen years, the onset of the condition typically starts during reproductive years.
A general OBGYN can help diagnose your symptoms as endometriosis and determine the best treatment for you but many may miss the diagnosis if they don’t deal with many patients with endometriosis.
Endometriosis Symptoms
The most common symptoms that women experience if they have endometriosis include pain, infertility, and digestive problems. Not all women experience symptoms, but pain is the most common symptom and can be:
- Painful menstrual cramps
- Chronic pain the lower abdomen or intestines
- Pain during or after sex
- Painful bowel movements or pain when urinating during menstrual periods
- Right shoulder pain or upper abdominal pain
- Rare pneumothorax
- Leg or hip pain
Pain from Endometriosis is caused by the benign growth of the endometrial lining cells in “ectopic” locations. These growths bleed in the same way as the uterus during your period – bleed and scar and cause inflammation of the surrounding structures. Other problems can result such as your fallopian tubes being blocked, inflammation, and scar tissue around your uterus, intestines, bladder as well as larger focal implants that press on neighboring structures causing pain.
Diagnosing Endometriosis
In addition to discussing your symptoms with your gynecologist, he or she may suggest another exam to diagnose endometriosis. During a pelvic exam, your doctor may be able to feel for large cysts or adhesions behind your uterus. An ultrasound is a first line evaluation for anyone with pelvic pain but in many reveals “normal” findings despite significant endometriosis. An MRI (with an endometriosis protocol) can be very useful in complex presentations.
Surgery is the only way to confirm that you have endometriosis. A general OBGYN may perform a laparoscopic procedure for pelvic pain to confirm the diagnosis of endometriosis BUT the extent of treatment depends on their experience with the disease and their surgical expertise.
Symptom Management and Treatment in Seattle, WA
There is, in some cases, no complete cure for endometriosis, however, talk initially with your doctor about your situation and the best symptoms management options for you.
- If you are not trying to get pregnant, hormonal birth control (OCPs) is usually the first step to help reduce pain and bleeding, if those are the presenting complaints, as no diagnosis has been made and many get great relief from OCPs w/o a diagnosis as frequently pain with ones period (dysmenorrhea) is not uncommon without other pathology present.
- If you are trying to get pregnant there is no medication to treat endometriosis as one needs to suppress the ovarian function which then would impede pursuit of pregnancy. NSAIDs and sometimes periodic narcotics for pain can be helpful but also Toradol may offer a non narcotic relief option.
- Surgery is typically recommended when symptoms are severe, other treatments haven’t worked, or you are having fertility problems. During surgery, the endometriotic growths should be removed as opposed to ablated, which may provide extended relief from pain depending on the extent of surgery.
If you’re experiencing pelvic pain, severe pain related to your period, problems with infertility combined with pain, have had a diagnosis of endometriosis and prior surgical treatment schedule an appointment to talk with Dr. Heath Miller about endometriosis.