Lesson 3: Your Doctor, Your Options
Endometriosis
Endometriosis, or endo for short, is a chronic condition that affects between 10 and 20 percent of the female population of reproductive age in the US. The actual percentage of women affected by endo could be much higher as the only way to diagnose it is through laparoscopic surgery. There are no hard and fast warning signs for endo, but some symptoms include:
- Pain before and during periods
- Painful intercourse
- Painful urination during periods
- Painful bowel movements during periods
- Diarrhea, constipation, or nausea during periods
- Infertility
It is possible that endo is inherited, so if your mother, or sister(s), have been diagnosed, and you have any of the symptoms of it, you should talk with your doctor about a diagnostic laparoscopy.
It is still unknown what causes endo, but many theories have been put forth, none of which we will discuss in detail in this course. However, if you are interested in learning more about endometriosis, I highly recommend the Endometriosis Association's web site.
Endo is caused by the growth of endometrium (the lining of the uterus) like tissue outside of the uterus. The growth is most commonly found in the pelvic area including around the ovaries, fallopian tubes, exterior of the uterus, between the vagina and the bowels, the ligaments that support the uterus, and the lining of the pelvic area. It has also been found in other areas of the body including the bladder, bowels, cervix, vagina, abdominal surgical scars, and as far away from the pelvic area as the chest, arms, and legs, however this is fairly rare.
There are four 'levels' or stages of endo:
- Minimal – Stage I
- Mild – Stage II
- Moderate – Stage III
- Severe – Stage VI
Along with the different stages of this condition, there are also different treatment options, but there is no cure. Treatment can range from pain medication to control the cramping to surgery to remove the growths or a hysterectomy. Deciding on how to treat the endo is up to you and the symptoms that you have. If you only suffer from minor pain associated with your period, then taking painkillers may be your best option.
If, on the other hand, the endo is extensive and has caused scarring of the fallopian tubes, then surgery to remove the growths and correct what scarring is possible might be your best option, especially if pregnancy is your goal in the near future. The surgical removal of the growths can be done at the same time the diagnosis of endo is performed through laparoscopy. Possible removal of any growths found should be discussed with your doctor before the laparoscopy is scheduled.
Another treatment option is with the use of synthetic hormones to control the endo. This would include the use of birth control pills, as well as other synthetic hormones, that makes the woman's body think she is either pregnant or in menopause. When these medications are used to either control the growth or to reduce the amount of endo, a follow up plan for pregnancy should also have been fully discussed.
About 35% of women diagnosed with endometriosis will suffer with some form of infertility because of it. All possible treatment options must be fully discussed with your partner and your doctor before any decision is made. If pregnancy is your goal, your doctor must know.
