Endometriosis is a common condition in which part of the uterine lining or glands are located outside of the uterus. Typically the glandular tissue is located in the pelvis and abdomen. The most common symptoms of endometriosis are painful menstrual cycles, pain with intercourse, infertility or an ovarian mass. In infertile women, the incidence has been reported as high as 50%. In women who have pelvic or abdominal pain, the incidence has been reported as high as 70% making this a condition which can be underdiagnosed.
Women are evaluated for endometriosis by undergoing a physical exam and a pelvic ultrasound. The only way to definitively diagnose endometriosis is with a surgical procedure called a laparoscopy. Surgical diagnosis is not always necessary to begin treatment for painful symptoms. There are medical treatments for endometriosis that include oral contraceptive pills, injectable contraception, levonorgestrel IUD and leuprolide. These medications are used to prevent menstrual bleeding and therefore decrease pain symptoms. Medical treatments are not used in women that are trying to get pregnant. In women who are trying to get pregnant with endometriosis, the treatment includes surgery or undergoing fertility treatments.
Women who experience infertility surgical treatment for endometriosis experience improved pregnancy rates even in patients with minimal or mild endometriosis. Surgical management may also help to improve pain symptoms. Fertility treatment for endometriosis may entail surgery, ovulation induction, intrauterine insemination (IUI) or in vitro fertilization (IVF). The ultimate cure for endometriosis is a complete hysterectomy with removal of the uterus, tubes and ovaries. Women with endometriosis are not alone and there are multiple treatment options available to improve quality of life and improve fertility! Please talk to your primary care physician or OB/GYN if you are experiencing any of these symptoms.