Endometriosis - Symptoms, Diagnosis And Treatment

At SteadyHealth, we believe that every woman of reproductive age should be familiar with the symptoms of common female diseases. This allows you to realize something is wrong more quickly and makes prompt medical attention possible.

While endometriosis is relatively prevalent, few women who were not diagnosed with the disease are familiar with the disease and its symptoms. Since it is Endometriosis Awareness Week, this is the perfect importunity to remedy that! We'll look what endometriosis is, its symptoms, diagnosis, and treatment. 

What Is Endometriosis? What Symptoms Can You Expect?

What happens in a woman who has endometriosis? Endometrial tissues, which would typically line only the uterus and be shed each month during menstruation, affect and grow inside surrounding organs as well. The fallopian tubes, ovaries, bladder, intestines and other nearby organs can all be overtaken by endometrial tissues. Because the endometrial lining growing in other organs cannot be expelled during menstruation, cysts, adhesions and invasive nodules can quickly result.

The cause of endometriosis is still a bit of a mystery within the medical community. There are some theories, however. Research has shown that endometriosis has a strong genetic component. Immune system response, hormones, environmental triggers and stem cells may all play a role in its development too. 

Endometriosis can occur in four different stages. These stages are diagnosed on the basis of the depth, location, and amount of endometrial “implants”, as they are known. Healthcare providers will examine whether a woman with endometriosis has blocked fallopian tubes, and what the extent of adhesions or scarring is. The stages of endometriosis are as follows:

• Stage I — minimal endometriosis

• Stage II — mild endometriosis

• Stage III — moderate endometriosis

• Stage IV — severe endometriosis

You may think that the symptoms of endometriosis get worse with its severity, but although that thought would appear to be the result of common sense, this is rarely the case. In fact, symptoms may be worse in earlier stages and then disappear as more damage occurs within the affected organs. This is one reason to always pay close attention to symptoms that occur within the pelvic area.

It is important to note that many women who suffer from endometriosis do not have any obvious symptoms, and many women living with the condition remain unaware of this fact. Sometimes, the first symptom of endometriosis is the inability to get pregnant. Where symptoms do exist, they can include:

• Pain. Pelvic pain or discomfort is a common and characteristic symptom of endometriosis. Pain can also occur during menstruation, sexual intercourse, or bowel movements. Some women experience rectal pain, and others notice a lower back pain — especially in the days before their period is due.

• Irregular bleeding. Bleeding in between menstrual periods can indicate endometriosis, as can unusually heavy periods. Vaginal bleeding after intercourse and blood in a bowel movement are also associated with the disease.

• Nausea, vomiting and fatigue are symptoms of endometriosis.

• Infertility, ectopic pregnancy, and miscarriage are all among the most unwelcome symptoms of endometriosis. These come as the result of damage within the reproductive system.

Pelvic pain, irregular bleeding and pain after sexual intercourse should always be reasons for a woman to seek medical assistance. Regular unexplained nausea and vomiting, as well as constant fatigue, also often indicate gynecological problems. These symptoms are not enough to come to the conclusion that a woman has endometriosis, as many other reproductive conditions can cause the same symptoms. That would take us to the next section — in which we look at how endometriosis is diagnosed.

Endometriosis — Diagnosis And Treatment Options

Women who experience suspicious pelvic symptoms, bleeding, an ectopic pregnancy, repeated miscarriages or infertility may have taken that first step to see their family doctor, or an obstetrician/gynecologist. You will discuss your symptoms, medical history, and risk factors during this first appointment. Endometriosis has a strong genetic component — if your mother has or had endometriosis, you are around seven times more likely to develop the disease yourself. This explains why it is important to familiarize your doctor with your medical history.

Soon enough, your healthcare provider will come to the conclusion that endometriosis is a very real possibility.

A woman's symptoms, medical history and risk factors are often enough to presume endometriosis. An endometrial biopsy is, however, the only way to diagnose the disease with certainty. A laparoscopy is a pelvic operation that is carried out through small incisions in the abdomen. Endometrial implants in organs surrounding the uterus can actually be removed during a laparoscopic procedure, but it will initially be used to visually assess the presence of endometrial implants and to take an endometrial biopsy that can then be examined in a laboratory.

Treating Endometriosis

Endometriosis cannot be permanently cured, but it can often be managed very successfully, allowing patients to live fulfilling lives not seriously impacted by the disease. The path an individual woman with endometriosis and her doctor will choose depends on many factors including her age, the severity of her symptoms, the extent of endometrial implants and whether she would like to have children. Pain and infertility are the two biggest concerns when it comes to the management of endometriosis. 

Endometriosis treatment options include:

• Expectant management — also known as a “wait and see” approach. This approach is suitable for those women who do not experience symptoms and do not want to get pregnant. Women who choose this option would have checkups every six to 12 months to evaluate whether the condition has changed or progressed. 

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to manage the pain.

• Hormonal medications to prevent the endometriosis from worsening, or to manage the symptoms. For women who do not want to get pregnant, combined oral contraceptives (the birth control pill) many decrease symptoms.

• Laparoscopic excision surgery to remove endometrial implants. While this surgery does not prevent endometrial growths from returning, it does tend to temporarily improve symptoms. The surgery is also the biggest hope for women who would like to conceive naturally. The chances of getting naturally are the biggest within 12 months of the laparoscopic excision surgery.

• Hysterectomy for women with severe endometriosis who do not want to get pregnant.

• IVF treatment for women with endometriosis-related blocked fallopian tubes. Research suggests that IVF success rates are slightly lower for women who have endometriosis, but also that most endometriosis patients who have IVF manage to get pregnant and stay pregnant.

The surgery removes all endometrial growths, returns the normal function of the affected organs, and will result in the elimination or great reduction of endometriosis symptoms. Women who have been diagnosed with endometriosis and are interested in undergoing excision surgery should consult their specialist about the risks and benefits in their own personal case before going ahead with the surgery. During these consultations, it is always important to keep in mind that the surgery does not prevent endometrial implants from returning.

Endometriosis can be managed in numerous different ways, and some women choose to incorporate alternative medicine into their treatment plans as well. This overview only covers conventional treatments, but it is good to note that acupuncture and traditional Chinese approaches are often beneficial as well. Consult your doctor before you add alternative medicine to your management routine.