Symptoms, treatment options, and fertility implications of a common medical problem
What is endometriosis? How does it develop? What can I do to treat it? Does endometriosis mean I cannot have children?
These are common questions that women ask when they’re diagnosed with endometriosis. Between what they hear from friends, family, the internet, TV, and Dr. Google, women are often terror-stricken at the mere mention of the word. However, many women might not realize how common of a problem it is (it affects an estimated 1 in 10 women during their reproductive years) – or that the painful intercourse and/or unbearable menstrual cramps they are experiencing could be symptoms. Hopefully, the following information will help allay some fears about this common medical problem and encourage women to talk to their doctors so they can find the treatment they need.
What is endometriosis?
Endometriosis is a disorder where endometrial cells, or the cells that normally line the inside of the uterus, are found in areas of the body outside of the uterus such as on the fallopian tubes, the ovaries or the lining of the pelvis. These cells continue to act as if they are lining the uterus, building up and breaking down during a woman’s menstrual cycle, which can cause painful symptoms.
What causes these misplaced uterus cells?
There are several theories about how these cells make their way outside of the uterus. One theory is that that they are not misplaced cells at all – but that they are the cells lining the abdomen, called the peritoneum, undergoing changes in order to evolve into endometrial cells. Another theory is that menstrual flow exiting through the fallopian tubes spreads the endometrial cells into the abdomen. None of these theories have been proven definitively. It appears that, like so many other things in medicine, there are multiple factors that go into these endometrial cells’ ability to function outside of the uterus.
Symptoms of endometriosis
Endometrial cells are hormonally activated during a woman’s menstrual cycle. Each month, wherever they are located, the cells will form endometrial glands, as if they were building up tissue inside the uterus in order to prepare for pregnancy. This can cause local inflammation and, over time, scarring and pain. It is through this process, we believe, that women start to have chronic symptoms of endometriosis.
The symptoms that women usually notice are:
- painful menstrual cycles (beyond normal cramping)
- pain during sex
- difficulty becoming pregnant
A major challenge in diagnosing endometriosis is that these symptoms are quite common in women and are non-specific. Frequently, doctors will start medical treatment for a patient that they think has endometriosis. However, the only way to make a formal diagnosis is with surgery. During surgery, the surgeon examines the abdomen and pelvis for any signs of endometriosis. If they can’t see any obvious changes associated with endometriosis, they can get a biopsy from the lining of the abdomen or pelvis that would indicate whether endometriosis exists.
Treatment options:
There is a range of treatment options for patients diagnosed with endometriosis, including:
- over-the-counter pain medications (for example, Motrin or Aleve)
- hormonal birth controls that suppress ovulation
- medications that cause medical menopause
- surgery
The ultimate treatment for endometriosis is menopause, either natural, medically induced, or surgical.
Can I become pregnant if I suffer from endometriosis?
If menopause is the ultimate treatment, then the biggest question on patients’ minds is: “Can I get pregnant?” A diagnosis of endometriosis does not mean you will never have children, but it may be more challenging to conceive. Women who are having difficulty getting pregnant should talk to their provider about options. There also reproductive specialists who can help. Many women who suffer from endometriosis are still able to conceive and give birth to healthy babies.
Endometriosis clinical research studies
Endometriosis is a complex disease that we continue to learn more about through advances in medical research. VPFW is working with Clinical Research Partners on clinical studies to help women suffering from endometriosis and other gynecologic conditions.
If you are interested in helping improve your life and the lives of other women by participating in a paid clinical research trial, please fill out the form below and we will reach out to you as studies become available.
To schedule an appointment with a VPFW provider, you can call us at 804-897-2100 or set an appointment online.