What causes endometriosis?

The most widely accepted cause of endometriosis is retrograde menstruation. This occurs when tissue from the uterine lining, called endometrial tissue, flows backward through your fallopian tubes while you're menstruating and implants in various sites, most commonly in the pelvis. The tissue gets trapped and can't leave the body. However, no matter where it is in the body, endometrial tissue still responds to your hormones each month. This tissue can become inflamed, bleed and develop into scar tissue. When the tissue is attached to organs in the pelvic and abdominal cavities, it may cause severe pain, infertility and other problems. Other theories suggest that alterations in the immune system response, hormonal imbalances or environmental causes may be related to the development of endometriosis. Experts find strong evidence suggesting a genetic link.

What does endometriosis feel like?

Pain in the pelvic region ranging from very mild to severe is the most common symptom, but you may not experience any symptoms. Some women describe the pain as sharp and burning. It may last all month long, but is usually worse during menstruation, deep penetration during intercourse or bowel movements. Other symptoms may include: Diarrhea and painful bowel movements especially during menstruation Abdominal tenderness Intestinal pain Abnormal menstrual bleeding Severe menstrual cramps Pelvic pain distinct from menstrual cramps Backache Pain during or after sexual penetration Painful bowel movements Pain with exercise Pain with urination Painful pelvic examination Infertility

How can I be sure I'm being diagnosed correctly if pain associated with the disease can often be confused with other medical problems?

Even without a definitive diagnosis, your health care professional may still prescribe hormonal treatments. If the pain decreases, there is an assumption that endometriosis was the cause of the pain. However, endometriosis cannot be definitively diagnosed without laparoscopy and biopsy.

Can I get pregnant if I have endometriosis?

Yes, you can. The majority of women who have endometriosis are fertile, and there are many who have the disease and go on to have children. However, the likelihood of infertility does increase in women with endometriosis of all stages.

Is there any way I can prevent endometriosis?

No. Experts don't know definitively what causes the condition so they don't know how to prevent it. Research suggests that having children early, having more than one child and long-term use of oral contraceptives may reduce the risk. However, many other factors determine if and when a woman should have children.

What options are available to treat endometriosis?

The most common medical therapies for endometriosis are hormonal contraceptives and other hormonal regimens, such as GnRH agonists (gonadotropin-releasing hormone drugs), which reduce estrogen release, limiting the effects of hormones on the endometrial tissue. Danazol, a synthetic androgen, is also used, but it can cause some undesirable side effects, including weight gain, hirsutism (hair growth) and lowering of the voice. Surgical treatments range from removing only the endometrial implants via laparoscopy to removing the uterus and ovaries.

How do I know which is the best treatment option for my case of endometriosis?

It's tough to know which treatment is best for you, especially since very few comparative studies have been conducted to determine which approach is better. There are pros and cons for all treatments. Most women with the disease can find relief via medical therapies, and birth control pills may be used indefinitely to manage symptoms. Other women turn to surgery. However, many women try to avoid surgery to remove the uterus because it's a serious procedure that will leave them infertile and carries no guarantee of banishing endometriosis forever. Because of the risks associated with surgery, the usual course of treatment is to proceed from the least invasive or risky to the more invasive treatment. That means medical treatment first. If that doesn't work, your doctor may recommend laparoscopy, with surgery to remove the uterus as a last resort.

Endometriosis

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