Know when to seek treatment for endometriosis and what treatment options might be available to you.
If your day-to-day activities are affected by painful periods, you’re not alone. Many women live with cramping, bloating and more throughout their cycles. And while they may not always indicate a serious health concern, it’s important to talk with your gynecologist about your symptoms because they can help you rule out conditions like endometriosis.
Find out what endometriosis is and when surgery might be necessary to find relief.
What is endometriosis?
Endometriosis is a health issue that can affect women through their childbearing years. It occurs when the tissue that typically lines your uterus grows in other parts of your body, most commonly in the lower abdomen, affecting the ovaries, fallopian tubes and tissue lining the pelvis.
“With endometriosis, the endometrial tissue outside the uterus acts the same way as it does inside the uterus, responding to the hormones the ovaries make each month, thickening and breaking down,” says Jennifer Gell, MD, an OB-GYN and division chief of reproductive endocrinology at Geisinger. “But because the tissue is outside the uterus on surfaces where it does not belong, inflammation occurs.”
This can cause irritation and scarring of the surrounding tissue. It can also cause symptoms including:
- Bleeding between periods
- Cramps during the weeks around menstruation
- Discomfort during bowel movements
- Heavy menstrual bleeding
- Lower back pain
- Pain during intercourse
- Painful periods
Treatments for endometriosis include:
- Over-the-counter pain medication to reduce inflammation and pain
- Contraceptives such as birth control pills, the patch or the ring
- Other types of hormone therapy
However, many of these treatment options also prevent women from trying to conceive, and they don’t treat infertility related to endometriosis.
“About one-third to one-half of women with endometriosis have trouble conceiving naturally without some medical intervention,” says Dr. Gell. For these women, a surgical procedure may be necessary.
One procedure used to treat endometriosis is laparoscopic surgery to remove scar tissue, endometriosis and cysts that build up as a result of endometriosis. During the procedure, a surgeon will insert a tube with a small camera on the end into a small incision in the abdomen to find and remove the endometriosis.
“Laparoscopic surgery that keeps the ovaries and uterus intact may help a woman who’s trying to get pregnant, and it can reduce pain for other patients,” says Dr. Gell. “However, endometriosis and pain can come back after surgery.”
In some cases, more traditional abdominal surgery using a larger incision may be done to remove widespread endometriosis. In rare cases, a hysterectomy and oophorectomy may be necessary to fully treat advanced endometriosis. A hysterectomy is a surgical procedure to remove the uterus and cervix. An oophorectomy is a surgery to remove the ovaries.
Removing the ovaries will cause estrogen levels to drop, which will most likely reduce pain symptoms. However, this may also spur menopause symptoms. “This type of surgery is often a last resort for women with unmanageable pain who’ve tried other treatments with no success,” says Dr. Gell.
When trying to treat endometriosis, work with your doctor to find the best treatment option for you. With options from medications to surgery available, you can find relief from your pain.