Five Things You Should Know
March is National Endometriosis Awareness Month, so it's time to increase your knowledge about a disease that can cause debilitating pain and is estimated to affect 6.3 million women in the United States.
"When the Endometriosis Association was founded in 1980, endometriosis was commonly thought of as a disease of the single, white career woman," says Carol Drury, Education Program Coordinator and Associate Director. "That is certainly not the case! We estimate that more than 89 million girls and women around the world — of all races, single and married, working inside or outside of the home — are currently affected by endo. Endo has been diagnosed in girls as young as 8 — prior to their first menses — and can also be found in women who are post-menopausal."
1. Endometriosis May Be Found in Many Parts of the BodyEndometriosis gets its name from the "endometrium," which is the tissue lining the inside of the uterus. With endometriosis, the tissue grows on other parts of the body, which may include the ovaries, the outer surface of the uterus, the lining of the pelvic cavity, the tissues that hold the uterus in place or the Fallopian tubes. In some cases, endometriosis is found in other places such as the cervix, bladder or rectum, and in rare cases it can be found in such places as the lungs or brain.
2. Endometriosis Can Be DebilitatingGrowths of endometriosis are non-cancerous, but endometriosis can cause health problems, including infertility and debilitating pain. Why? Each month, the endometriosis responds to the hormones produced during the menstrual cycle in the same way that the endometrium does — it builds up, breaks down and sheds. While menstrual blood flows from the uterus and out of the body through the vagina, the blood and tissue shed from the endometrial growths have no where to go. As a woman gets older, the endometriosis growths may expand by adding extra tissue and blood, which causes symptoms to worsen.
There is a correlation between the amount of endometriosis and pain; however, even mild endometriosis can cause severe pain if the growths are located on nerve endings.
3. Everyone's Endometriosis Symptoms Are Not the SameEndometriosis can often go undiagnosed or be misdiagnosed. "Girls and their parents, women, and even doctors do not know that pain with menstrual periods is not normal if it interferes with daily activities," says Drury. "If discomfort during a period pain cannot be alleviated by use of an over-the-counter analgesic and a heating pad, endometriosis should be suspected."
In addition, women's pain may be discounted. "We hear too many stories of women who have been told their pain is 'all in your head,'" Drury says.
Endometriosis symptoms can include:
- Painful menstrual cramps
- Chronic pain in lower back or pelvis
- Pain during or after sex
- Intestinal pain
- Painful bowel movements or painful urination during menstrual periods
- Spotting or bleeding between menstrual periods
- Diarrhea, constipation, bloating, or nausea, especially during menstrual periods
If you have these symptoms, be aware that many of them are similar to other conditions such as fibroids, kidney stones, irritable bowel syndrome and pelvic inflammatory disease. This is one of the reasons endometriosis can be so difficult to diagnose. "The symptoms are frequently confusing, overlap with other diseases, can be subtle, can be intermittent," says George M. Grunert, M.D., a fertility doctor with Fertility Specialists of Houston. "The ‘classic triad’ of symptoms — pain, bleeding and infertility — are present in the minority of patients. Most women with endometriosis have one, but not all of these at the same time."
Your physician may perform a pelvic exam and an ultrasound to find large cysts or scars; however, the only way to definitively diagnose endometriosis is with a laparoscopy, which is a minor surgical procedure that allows the doctor to look inside your abdomen to see endometriosis tissue.