Endometriosis: Causes, Symptoms, Risk Factors, Prevention and Treatment

Endometriosis can have a huge impact on a woman’s life. According to the Office on Women’s Health, more than 11% of American women may be suffering from it. It’s a disorder that affects mostly those in their 30s and 40s and can often be chronic and painful if not diagnosed and treated.  

Here we look at what this painful disorder is, how it can be diagnosed and treated and when to see a doctor.

What Is Endometriosis?

Endometriosis is a common health issue for women and occurs when tissue similar to the uterus lining starts to grow outside the womb. It can be found spreading to areas such as the ovaries, fallopian tubes, and the outer parts of the uterus. 

In some cases, the tissue can grow in the cervix, vagina and vulva and even the bowel and bladder. In very rare circumstances it may appear in more remote areas of the body such as the lungs and brain.

What are the Causes and Risk Factors Associated with Endometriosis?

We still don’t know what leads to endometriosis developing but research has suggested a few different causes. These might include a genetic predisposition the individual may have, problems with a compromised immune system, hormone imbalances and common female reproductive issues such as retrograde menstrual flow. 

There is some evidence that endometriosis can be caused by surgery such as a c-section or hysterectomy when tissue is accidentally transferred to another part of the body. 

There are several risk factors associated with the development of endometriosis. It is more common in women who have never given birth, for example, and those who started their period at an early age. Short menstrual cycles and heavy periods can also be influencing factors.

Endometriosis symptoms

Symptoms of Endometriosis

The main symptom of endometriosis is pain in the pelvic region which can often come on at the same time as menstruation. While menstrual pain is not unusual, those with endometriosis describe their pain as more severe than usual. 

Individuals can also experience pain during intercourse and when going to the toilet. They may have bleeding between periods and have other symptoms such as nausea, tiredness and bloating, constipation or diarrhea.

Endometriosis Diagnosis

The doctor will first ask their patient to describe their symptoms. If endometriosis is suspected, several tests can be carried out:

  • Pelvic exam: The doctor will manually examine the pelvis for signs of abnormality such as cysts and scars. However, this is not a definitive way to test for endometriosis as it will only show up if cysts have developed. 
  • Ultrasound: This is a device that can also detect the presence of cysts in the area of the uterus but again, this is not a method which can return a definitive diagnosis. 
  • MRI scan: This gives a detailed image of the area of concern and may show signs that endometriosis has developed and where it has spread to.
  • Laparoscopy: This involves the insertion of a camera into a small incision in the abdomen, usually carried out under a general anesthetic.

How is Endometriosis Treated?

There are typically two options when someone has been diagnosed with endometriosis – medication and/or surgery. Much depends on how severe the symptoms are and whether the affected individual  wishes to become pregnant at a later date. 

Over the counter pain medications such as Ibuprofen and other non-steroidal anti-inflammatory drugs can help control issues such as menstrual pain. 

If the individual is not intending to get pregnant, the doctor can also advise on hormone therapy as it is sometimes effective at controlling pain. The problem here is that endometriosis can return once the hormone therapy has stopped. 

Common approaches include taking hormonal contraceptives such as birth control pills or taking medications that block ovarian stimulating hormones. 

If someone is trying to get pregnant, conservative surgery is another option that can help remove the endometriosis tissue while still keeping the ovaries and uterus intact. This can also be a good option if someone is suffering from chronic, severe pain. 

Surgery is usually carried out using a laparoscope which is inserted into the abdomen through a small opening under general anesthetic.

A more invasive approach if the individual is not intending to get pregnant is to carry out a hysterectomy and remove the ovaries. However, experts are moving increasingly away from this approach and focusing on removing the endometriosis tissue itself.

When to See a Doctor

If you have any of the signs and symptoms of endometriosis, it’s important to make an appointment to see your doctor. This is a difficult disorder for many women and early diagnosis can certainly improve the outcome for the individual.