Many women bemoan that cramping feeling that comes with their menstrual cycles, but for others that time of the month means more intense pain that can hamper their daily life. That's a sign of endometriosis, which affects more than 6 million women in the United States.
What is endometriosis?
"The endometrium tissue that lines the uterus starts growing outside the uterus," says Bob Field, MD, a gynecologist with
Annadel Medical Group in Santa Rosa. "It can implant itself on the ovaries, fallopian tubes, peritoneum, vagina, cervix or bladder, among other areas. The problem is that this tissue responds as your uterine lining does during the menstrual cycle, but unlike the uterine lining, which is shed through the body during menstruation, the implanted endometrial tissue can't leave the body. That can cause bleeding, inflammation and scarring, which in turn can cause a great deal of pain, especially before or during a woman's period."
Who does it affect?
Any woman who menstruates is susceptible to endometriosis, although it's most common in women in their 30s and 40s. While there is no one cause of endometriosis, women can be at higher risk if they have a family history of the problem, haven't been pregnant, have longer-than-normal periods or have a shorter than usual time between menstrual cycles. Hormonal and autoimmune issues may also potentially play a role.
What are the symptoms?
While some women don't feel symptoms, pain is usually the major symptom associated with endometriosis. "In addition to experiencing pain during the menstrual cycle, some women feel it during or after sex or when they go to the bathroom, depending on where the tissue implants are located," Dr. Field says. "Others can have chronic pain in the lower back or pelvis, or report digestion problems." While a women with endometriosis can potentially become pregnant, it can also be a major hurdle—between 40 and 50 percent of American women who struggle with infertility also have endometriosis, Dr. Field says. Endometriosis has also been linked to allergies, chronic fatigue syndrome, fibromyalgia and autoimmune diseases.
How do I know if I have endometriosis?
A gynecologist can do a pelvic exam or imaging test to check for endometriosis, but usually a definitive diagnosis is made through laparoscopy surgery in the pelvis.
How is endometriosis treated?
There's no cure for endometriosis, but doctors can suggest different ways to manage or reduce the pain.
"If a woman isn't trying to conceive, she can be prescribed a hormone treatment, such as oral birth control pills or shots," Dr. Field says. "Those treatments control the production of hormones such as estrogen or progesterone, which can slow the growth of the tissue and lessen the severity of symptoms. However, once the treatment is stopped, the tissues can start growing again and the pain can return. It's important to discuss these options thoroughly with a physician." For extreme cases or for women who want to get pregnant and can't take hormones, surgery may be recommended so the doctor can remove the tissue implants. Hormone treatment is usually prescribed after surgery to prevent tissue growths from re-forming.
Lifestyle changes may help reduce the pain of endometriosis, Dr. Field says. "Women can try lowering their estrogen levels through regular exercise, reducing their body fat if it's above normal, and limiting their intake of alcoholic and caffeinated drinks." Some women also find relief through acupuncture, chiropractic or herbal treatments; again, any potential treatment should be discussed with a physician.
For more information on Annadel Medical Group, click here. For more information on Dr. Field, click