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Endometriosis (say "en-doh-mee-tree-OH-sus") is a problem many women have during their childbearing years. It means that a type of tissue that lines your uterus is also growing outside your uterus. The clumps of tissue that grow outside your uterus are called implants. They usually grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases, they spread to areas beyond the belly.
Endometriosis usually isn't dangerous. But it can cause pain and other problems.
Experts aren't sure what causes endometriosis. Maybe endometrial cells get into the belly because of heavy bleeding or problems with reproductive organs. Or these cells may not be killed by the immune system outside the uterus. Or the cells might be carried to other parts of the body by blood or lymph fluid.
The most common symptoms are pain, bleeding, and trouble getting pregnant. You may have pain in your lower belly, rectum or vagina, or lower back. Some women have heavy periods, bleeding between periods, bleeding after sex, or blood in their urine or stool. Symptoms often are most severe before and during your menstrual period.
Your doctor will ask questions about your symptoms, periods, past health, and family medical history. You may also have a pelvic exam. This may include checking both your vagina and rectum. The only way to find out for sure if you have endometriosis is to have a surgery called laparoscopy.
Treatment choices depend on whether you want to control pain or you want to get pregnant. For pain and bleeding, you can try medicines or have surgery to remove the endometrial tissue and scar tissue. If you want to get pregnant, you may need surgery to remove the endometrial tissue.
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Experts don't know what causes endometriosis. But they do know that the female hormone estrogen makes the problem worse. Women have high levels of estrogen during their childbearing years. This is when women have endometriosis.
Here are some possible causes.
Your risk of endometriosis is higher if:
Some women with endometriosis don't have symptoms. Other women have symptoms that range from mild to severe. Symptoms may include:
Symptoms are often most severe just before and during your menstrual period. They get better as your period is ending. Some women, especially teens, have pain all the time.
Your uterus is lined with tissue called endometrium. When you have endometriosis, clumps of this tissue (called implants) form outside your uterus. The implants can be painful. Sometimes they form scar tissue or fluid-filled sacs (cysts). Scar tissue may make it hard to get pregnant.
Call a doctor immediately if you develop sudden, severe pelvic pain.
Call a doctor to schedule an appointment if:
To find out if you have endometriosis, your doctor will ask questions about your symptoms, periods, past health, and family history. (It sometimes runs in families.) You may also have a pelvic exam. This may include checking both your vagina and rectum.
Your exam, symptoms, and risk factors may strongly suggest that you have endometriosis. In that case, your doctor may have you try a nonsteroidal anti-inflammatory drug (NSAID) or hormone therapy before you have other tests. If treatment improves your symptoms after a few months, then it's more likely that you have endometriosis.
But the only way to be sure that you have it is to have a type of surgery called laparoscopy (say "lap-uh-ROSS-kuh-pee"). During this surgery, the doctor puts a thin, lighted tube through a small cut in your belly. This lets the doctor see what's inside your belly.
Treatment depends on how much pain you have and whether you want to get pregnant. Treatments include:
As a last resort for severe pain, some women have their uterus and ovaries removed (hysterectomy and oophorectomy).
If you're close to menopause, you may consider treatment with medicines rather than surgery. Endometriosis usually stops causing problems when you stop having periods.
Home treatment may ease the pain of endometriosis. You can try the following things along with your other treatments.
Use a heating pad or hot water bottle, or take a warm bath. Heat improves blood flow and may relieve pelvic pain.
Lie on your back and place a pillow under your knees. Or lie on your side and bring your knees up to your chest.
Exercise improves blood flow, increases pain-relieving endorphins naturally made by your body, and reduces pain.
Surgery to remove endometrial growths and scar tissue doesn't cure endometriosis. But it does offer short-term results for most women and long-term relief for a few. Surgery to remove the uterus and ovaries can cure endometriosis if growths are removed too.footnote 1
Surgery may be recommended when:
Surgery choices include:
CitationsAmerican College of Obstetricians and Gynecologists (2010, reaffirmed 2016). Management of endometriosis. ACOG Practice Bulletin No. 114. Obstetrics and Gynecology, 116(1): 225-236 .
Current as of: July 17, 2020
Author: Healthwise StaffMedical Review: Kathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineKevin C. Kiley MD - Obstetrics and Gynecology
Current as of: July 17, 2020
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Kevin C. Kiley MD - Obstetrics and Gynecology
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