Women have menstrual periods because their ovaries produce hormones each month that cause the tissue lining the uterus, called endometrial tissue, to thicken and eventually exit the body. When endometrial tissue grows in other parts of the body — which usually occurs in the pelvic region — the result is endometriosis.
An estimated 5 to 10 percent of women have this condition, which can cause such symptoms as pelvic pain and, in some cases, infertility. Ramya Narayanan, MD, an OB/GYN at Rush University Medical Center, sat down with Discover Rush Online to discuss five things every woman should know about endometriosis.
Endometriosis doesn’t equal infertility.
“Some people think that if they’re infertile, they must have endometriosis,” Narayanan says. “But not all infertility is related to endometriosis.” While the condition can lead to infertility and is therefore more common in infertile women, only 30 percent of these women have it. Moreover, women with properly managed endometriosis can often conceive even without in vitro fertilization or other fertility treatments.
Not all women should undergo the same treatment.
The best treatment for endometriosis depends on several factors, including a woman’s age, the severity of her pain and whether she plans to have children. For example, a woman with mild pain who does not wish to have children might be able to manage endometriosis by taking pain relievers and seeing a doctor regularly to keep any eye on any changes to her condition. For other women, hormonal therapies may slow the progression of the disease.
If a woman doesn’t respond well to medication, surgical procedures may be a good option: Minimally invasive surgery to remove endometrial growths and scar tissue has been shown to help some women conceive. For women with severe endometriosis who are no longer in their childbearing years, a hysterectomy might help to eliminate the majority of symptoms.
Treatments can have a big impact.
While a hysterectomy offers the only chance for a cure, other treatments can reduce or even eliminate symptoms for years. “This is not something most women have to suffer without relief,” Narayanan says. “If a treatment isn’t working, we can often adjust it or find something that will.”
Support is available.
The fight against endometriosis doesn’t have to end with medication and surgery. To cope with the many ways — from infertility to pain — that the condition can affect their daily lives, some women find it helpful to seek psychosocial support services, such as counseling or support groups. Narayanan recommends that women ask their OB/GYN about these kinds of services.
Staying informed is the best approach.
Women whose mothers, sisters or other female relatives have endometriosis may be slightly more likely to develop the condition themselves. But doctors don’t yet know exactly what causes endometriosis in the first place. “You don’t get endometriosis from eating the wrong thing, or from a lifestyle choice, or from anything you do,” Narayanan says. As a result, preventive measures don’t exist. The best approach is to be aware of the condition’s symptoms (see sidebar) and, if you experience any of them, talk to your doctor. Doctors can sometimes diagnose endometriosis after a pelvic exam, but usually they must perform a minimally invasive procedure called a laparoscopy — in which doctors insert a tiny camera through a small incision to examine the pelvis and abdomen — before making a definitive diagnosis.
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Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.