Endometriosis

What is endometriosis?

Endometriosis occurs when tissue similar to the lining of your uterus grows outside the uterus -- on your ovaries, fallopian tubes, or other pelvic organs. Each month, this tissue responds to your hormonal cycle: it thickens, breaks down, and tries to shed. Because it has no way to leave the body, it becomes trapped, causing inflammation, scar tissue, and adhesions. Over time, this can cause chronic pain and fertility challenges.

Symptoms

• Painful periods -- Pain significantly worse than typical cramping, often beginning before your period and lasting several days
• Chronic pelvic pain between periods
• Pain during intercourse
• Pain during bowel movements or urination, especially during your period
• Heavy or irregular bleeding
• Bloating and digestive issues
• Difficulty conceiving

Diagnosis

There is no single test for endometriosis. The team conducts a thorough evaluation including a review of your symptoms, menstrual history, family history, pelvic exam, and ultrasound. A trial of hormonal medication may help confirm the diagnosis. The most definitive diagnosis comes through laparoscopy -- a minimally invasive procedure that allows direct visualization and, if needed, removal of endometrial tissue.

Treatment

If you are not planning to become pregnant

Hormonal birth control is often the first-line treatment. These medications reduce or stop the monthly cycle, limiting tissue growth and reducing pain.

If you are planning to become pregnant

GnRH agonists temporarily pause your menstrual cycle and stop tissue growth, improving fertility outcomes. Laparoscopic surgery to remove endometrial growths can also increase your chances of conception.