Endometriosis occurs when the tissue that normally lines the uterus (the endometrium) grows outside of the uterus, often around the fallopian tubes, ovaries and walls of the pelvis. Occasionally this tissue may be found in areas outside the pelvis as well. The tissue acts as it normally would inside the uterus, swelling and bleeding during menstruation, but the bleeding has no way to exit the body. Over time, scar tissue can develop which can cause organs to bind together.
Symptoms may include very painful menstrual cramps which may progressively worsen over time; excessive menstrual bleeding; painful bowel movements or urination; diarrhea or constipation; bloating or nausea; pain during or after sex; and infertility.
It is estimated that roughly 11% of women, or about 6.5 million women in the United States, have this condition. If these symptoms sound familiar and you suspect you may be one of them, you should see your gynecologist for an evaluation. He or she will perform a pelvic exam and may order an ultrasound or MRI. If endometriosis is suspected your doctor may be prescribe hormonal therapy (such as a birth control pill, as one example) to try and ease symptoms.
If symptoms persist your doctor may perform a laparoscopy, a minimally invasive surgical procedure that involves making a tiny incision and inserting a thin lighted scope to view the structures of the pelvis. This is the only way to know for sure if you have endometriosis and if you do, the abnormal tissue may be removed laparoscopically as well. However, if the endometriosis is severe and widespread traditional open surgery may be necessary. In the most severe cases a hysterectomy and removal of the ovaries may be the best treatment, although this is reserved as a last resort.
Dr. Elena Poloukhine is a gynecologist and medical director of OB/GYN services at Day Kimball Medical Group, with practices in Putnam and Plainfield.