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What you need to know about endometriosis

Endometriosis affects the tissue lining the uterus, known as the endometrium. In this condition, tissue similar to the endometrium starts to grow outside the uterus, typically in the pelvic area. This tissue, called endometrial implants, can attach to various organs such as the ovaries, fallopian tubes, and the lining of the pelvis.

As a chronic condition, endometriosis can have a significant impact on a person's quality of life. It's essential for individuals with endometriosis to seek medical evaluation and management to alleviate their symptoms and, if desired, to address any fertility concerns.

Common endometriosis symptoms

Endometriosis can manifest with a variety of symptoms, and these may vary in intensity from person to person. Common symptoms of endometriosis include:

  • Painful menstrual cramps

  • Chronic pelvic pain

  • Painful intercourse

  • Painful bowel movements or urination

  • Heavy menstrual flow

  • Gastrointestinal symptoms

  • Fatigue

  • Infertility


If you suspect you have endometriosis or are experiencing any of these symptoms, consult with a St. Luke’s Health OB/GYN for a proper diagnosis and to discuss treatment options.

What causes endometriosis?

The exact causes of endometriosis are not fully understood, but several theories have been proposed to explain the development of this condition. Some potential factors and theories associated with the causes of endometriosis include:

  • Retrograde menstruation: This theory suggests that during menstruation, some of the menstrual blood containing endometrial cells flows backward through the fallopian tubes and into the pelvis instead of exiting the body. These displaced cells may then attach to pelvic organs and develop into endometriosis.

  • Genetic factors: Endometriosis tends to run in families, suggesting a genetic component. If close relatives, such as a mother or sister, have the condition, the risk of developing endometriosis may be higher.

  • Immune system dysfunction: Some researchers believe that issues with the immune system may fail to recognize and eliminate endometrial tissue growing outside the uterus, allowing it to thrive and cause endometriosis.

  • Hormonal factors: Estrogen, a female sex hormone, plays a significant role in the growth and shedding of the endometrial tissue during the menstrual cycle. An overproduction of estrogen or an imbalance of estrogen and progesterone may contribute to the development of endometriosis.

  • Environmental factors: Exposure to certain environmental toxins, chemicals, or pollutants may increase the risk of developing endometriosis, although more research is needed in this area.

  • Surgical scar implantation: Endometrial tissue can sometimes be transported to other parts of the body during surgeries like a C-section or hysterectomy, leading to the development of endometriosis.

  • Lymphatic or blood vessel spread: It's possible that endometrial cells can travel through the lymphatic system or bloodstream to other areas of the body and implant there.


How is endometriosis diagnosed

Your OB/GYN will use a variety of methods to diagnose endometriosis, such as:

  • Discussing your symptoms and medical history

  • Performing a pelvic examination

  • Using medical imaging tests such as ultrasound or MRI

  • Performing a laparoscopy, a minimally invasive surgical procedure

  • Taking a biopsy of the endometrial tissue


Early diagnosis and management of endometriosis can help alleviate symptoms and improve the quality of life.

Endometriosis treatment options

The treatment of endometriosis focuses on alleviating pain, managing symptoms, and, in some cases, improving fertility. The choice of treatment depends on the severity of the condition, the extent of the symptoms, and the individual's goals. Treatment options for endometriosis include:

  • Pain medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help relieve mild to moderate pain associated with endometriosis. For more severe pain, prescription pain relievers may be prescribed.

  • Hormone therapy:

    • Birth control pills: Oral contraceptives can regulate the menstrual cycle and reduce pain associated with endometriosis.

    • Hormonal IUD: An intrauterine device (IUD) that releases hormones can help alleviate symptoms by reducing menstrual flow and pain.

    • Gonadotropin-Releasing Hormone (GnRH) agonists: These medications temporarily induce a state of menopause to suppress the growth of endometrial tissue and reduce pain. They are typically used for short periods due to potential side effects.

  • Surgery:

    • Laparoscopy: As both a diagnostic and treatment tool, laparoscopy can remove or destroy endometrial implants and scar tissue.

    • Laparotomy: In severe cases, traditional surgery may be required to remove larger endometriosis growths or cysts.

  • Lifestyle and dietary changes: Some individuals find relief from endometriosis symptoms by making dietary changes, managing stress, and incorporating regular exercise into their routines. This may include an anti-inflammatory diet or physical therapy.

  • Fertility treatment: For individuals struggling with infertility due to endometriosis, fertility treatments such as in vitro fertilization (IVF) or intrauterine insemination (IUI) may be considered.


How can I manage endometriosis?

Lifestyle changes can play a significant role in managing endometriosis and reducing its symptoms. Here are some recommended lifestyle modifications that may help individuals with endometriosis:

  • Balanced diet: Maintain a well-balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins. Some women find relief from endometriosis symptoms by reducing their consumption of processed foods, caffeine, and alcohol.

  • Anti-inflammatory foods: Incorporate anti-inflammatory foods into your diet, such as fatty fish (e.g., salmon), turmeric, ginger, and green tea. These can help reduce inflammation and alleviate pain.

  • Regular exercise: Engage in regular physical activity to help manage pain and reduce inflammation. Exercise can also improve overall well-being and reduce stress.

  • Stress management: Stress can exacerbate endometriosis symptoms. Practices like yoga, meditation, and deep breathing exercises can help manage stress and improve your quality of life.

  • Adequate sleep: Ensure you get enough restorative sleep, as it is essential for overall health and can help with pain management.

  • Maintain a healthy weight: Being at a healthy weight can help reduce inflammation and improve symptoms. Consult with a healthcare provider or nutritionist if needed.

  • Avoid toxins: Reduce exposure to environmental toxins and endocrine-disrupting chemicals by choosing organic or natural cleaning products and personal care items.

  • Heat therapy: Applying heat (e.g., a hot water bottle or warm bath) to the lower abdomen can provide relief from cramps and discomfort.

  • Pelvic floor physical therapy: For some individuals, pelvic floor physical therapy can help alleviate pain and improve muscle tone and function in the pelvic area.


Endometriosis and pregnancy

Endometriosis can have an impact on pregnancy, and it's a concern for many individuals who are trying to conceive. Here are some key points to understand about endometriosis and its relationship with pregnancy:

  • Reduced fertility: Endometriosis can lead to reduced fertility. The exact mechanisms are not entirely clear, but it is thought to be related to the presence of endometrial tissue outside the uterus, which can affect the function of the ovaries, fallopian tubes, and the uterine environment. Some women with endometriosis may have a harder time becoming pregnant.

  • Increased risk of miscarriage: Women with endometriosis may face a slightly higher risk of miscarriage, particularly if the condition is severe. The presence of endometrial tissue in the pelvic area can create a less favorable environment for a developing embryo.

  • Pregnancy may improve symptoms: Some women experience a temporary relief of endometriosis symptoms during pregnancy. This is believed to be due to hormonal changes that occur during pregnancy.

  • Pregnancy after surgical treatment: Some individuals with endometriosis may undergo surgical treatment to remove endometrial growths. In some cases, this can improve fertility and increase the chances of a successful pregnancy.

Many women with endometriosis can still become pregnant and have healthy pregnancies. However, it may require additional support or treatments. Each person's situation is unique, and consulting with a St. Luke’s Health OB/GYN specializing in fertility and reproductive health can provide valuable insights and options tailored to your specific needs and circumstances.

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