Endometriosis is a common cause of pelvic pain, menstrual cramps, and also fertility problems. Endometriosis occurs when the inner lining of the uterus (the endometrium) flows backwards through the fallopian tubes and attaches to the inner organs of the pelvis. Once implanted, the endometrial tissue responds to your normal hormonal cycle, and may cause scarring and adhesions (attachments between internal organs which are not normally attached). Scarring in the pelvis is a major contributor to pelvic pain and menstrual cramps, and can also contribute to infertility.
Most women who have endometriosis are not aware that they have the condition.
Endometriosis can rarely be diagnosed by ultrasound or other types of imaging (e.g., CT scan or MRI) when it forms cysts on the ovaries; in most cases, endometriosis cannot be detected by imaging, blood tests, or other examinations. Ultimately, the diagnosis is usually made by laparoscopy, an outpatient procedure in which a telescope is inserted through the navel under anesthesia. For women who have not completed their families, making the diagnosis of endometriosis is important, since measures can be taken to treat endometriosis and to protect fertility.
Obviously, not every woman with menstrual cramps needs to undergo laparoscopy. As a general rule, women who require evaluation have chronic pain or cramps that have persisted for over 6 months. They have used simple measures like over-the-counter pain relievers (ibuprofen or naproxen) and/or birth control pills, but still miss time from work, school, or social/sexual activities because of pain. Women who have chronic pain which is severe enough to interfere with their activities despite simple treatment generally require further evaluation.
Endometriosis can usually be treated surgically using specialized laparoscopic techniques at the time of diagnosis. Generally this requires implants to be either excised or destroyed. Because endometriosis tends to be chronic and recurrent, most women will require ongoing treatment to prevent or treat recurrences.
At The Woman’s Health Pavilion, we have extensive experience in the diagnosis of endometriosis, as well as other causes of pelvic pain, menstrual cramps, and infertility. We do everything we can to determine the source of symptoms, and work closely with patients to develop a long-term treatment plan to keep them feeling their best. If you suffer from pelvic pain or menstrual cramps, are having difficulty conceiving, or suspect you may have endometriosis, you should schedule an appointment today for consultation.
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