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A Major Advancement in Treating Endometriosis Pain

Sunday, April 23, 2023 12:17 PM

Cropped shot of an attractive young woman lying on her sofa alone and suffering from period cramps at home. Ouch! My tummy!Endometriosis affects roughly 10% (190 million) of reproductive age women and girls globally.

It is a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility, according to the World Health Organization.

There is no cure for endometriosis but newer drugs that are not narcotics have been approved specifically for management of moderate to severe pain associated with endometriosis, said Sangeeta Senapati, MD, a NorthShore gynecologist and expert in pelvic pain.

In 2018, the U.S. Food and Drug Administration (FDA) approved elagolix (Orilissa®) for the treatment of pain associated with endometriosis—the first and only pill specifically approved for endometriosis pain-relief.

“For women who come to see us for management of pain symptoms, our recommendation may include the traditional pathway of starting with anti-inflammatory medications, and progressing to hormonal suppressant options, like combined hormonal birth control pills, progestins, or elagolix.” Dr. Senapati said. “Depending on the other symptoms present, we tailor treatment appropriately and that may include non-hormonal treatments targeting muscles or nerves. Or it may include surgery.”

Early intervention is important, she added.

“It’s important to understand how much of an impact the symptoms have on women and to recognize that painful periods aren’t always just painful periods,” Dr. Senapati said. “If women are voicing the concern, it should be acknowledged and appropriately triaged.”


What is endometriosis?

Endometriosis occurs when cells that are like the cells that line the inside of your uterus grow outside of your uterus. These cells form clumps of tissue 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.


What causes it?

Experts aren't sure what causes endometriosis. Problems with reproductive organs may cause endometrial cells to go up through the fallopian tubes and into the belly. And your immune system may not kill these cells outside the uterus like it should. These cells might be carried through the body by blood or lymph fluid.


What are the symptoms?

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. And you may have heavy periods, bleeding between periods, bleeding after sex, or blood in your urine or stool. Symptoms often are most severe before and during your menstrual period.


How is it diagnosed?

Your doctor will ask questions about your symptoms, menstrual periods, past health, and family medical history. You may also have a pelvic exam. And you may have imaging tests, such as a pelvic ultrasound or MRI. But to find out for sure if you have endometriosis, a surgery called laparoscopy is often used.

Millions of women suffer from urinary incontinence, endometriosis, fibroids, pelvic health disorders and other “female” problems. Yet a surprising number do not seek care. You can find a trusted physician by clicking this link or calling the Center for Pelvic Health at 224.251.2374.