The endometrium is just the lining of the uterus. This is what builds up and bleeds every month, causing your period.
Endometriosis is when this tissue from the lining of your uterus grows inside of your body in places where it shouldn't be.
This tissue will actually grow and bleed each month when you have a period and cause scar tissue to form.
It commonly occurs in the lining of the pelvis. It can deposit on the ovaries and cause bloody cysts to form there. It can cause scarring of the fallopian tubes. It can grow on the lining of the outside of your bladder or bowels.
That sounds really awful.
Yes, yes it is.
It can range from really mild to quite severe and becomes worse as years go by.
How do I know if I have endometriosis?
Well honestly, the only way I can for sure tell you if you have endometriosis is to do surgery and take a look, but that's not usually necessary...
The hallmark of endometriosis is extremely painful periods.
Pain will usually start right before your period does and is worst on the first and second days of period. Women may need to miss school or work because pain is so bad.
The type of pelvic pain experienced will depend on where the endometrial implants or scar tissue are located. You may have very painful bowel movements if there is scar tissue present near the bowels. You may have urinary issues if implants are on your bladder. Sex can be painful if scarring is near the vagina.
Endometriosis can affect fertility if implants scar the fallopian tubes or cysts grow on the ovaries.
There are a few ways to treat it...
1. Control periods
Treatment is anything that supresses your period. If we control your periods, we also control the bleeding on the inside, as well as prevent ovarian cysts from forming.
Any birth control option that lightens periods will help - birth control pill, patch, vaginal ring, progesterone IUD, or Depo-Provera shot.
The less periods, the better, so skipping periods is ideal.
Prevention is key to protecting your fertility.
2. Temporary menopause
Yep. If you're not ready to get pregnant for awhile, then we have medications we can use to put you into temporary menopause. Getting rid of your periods for awhile can give significant relief from the pain and prevent things from getting worse as well. We have both injectable meds and pills now as well. Side effects include hot flashes, so we can give very low-dose hormones to help reduce these symptoms if needed, without stimulating the endometriosis to grow.
3. Surgery
Laparoscopic surgery can be done to remove the scar tissue and endometrial implants and any ovarian cysts. We use a laser to zap the tissue - it's pretty cool.
We recommend surgery when you want to get pregnant soon because that will optimize fertility. Obviously if you're in chronic pain or have a large cyst, surgery is your best bet.
After surgery, if you're not planning on getting pregnant soon, then you need to do one of the above options to prevent it from coming back.
4. Pregnancy
Being pregnant is also great to prevent and suppress endometriosis because it gives you a nice long break from periods.
Pregnancy certainly has its side effects too (such as having a human baby grow inside you, and then having a child to raise for the next few decades), so we don't recommend it as treatment for endometriosis until you're ready for that..
...but you sure won't miss the periods.
The most important thing to know:
This is a process that gets worse over time.
Don't ignore this. You need to do something to prevent it from getting worse. There is no reason in the world why you should suffer through painful periods each month and risk your fertility.
It's not uncommon when women with significant endometriosis get into their 40s, they may need a hysterectomy - mostly because they get so tired of the pain. These can be some of the most difficult cases because of all the scar tissue.
Don't suffer for years, and then wind up needing difficult surgery. Prevention is key. Always.
As if that's not bad enough, endometriosis also increases your risk of ovarian cancer.
So, there's another big huge reason why taking the birth control pill for awhile might be a good idea.
The birth control pill not only helps your periods be lighter, shorter, and less painful, but it will allow you to skip periods altogether, prevent scar tissue, protect your fertility, lower your risk of needing surgery in the future, and lower your risk of ovarian cancer.
If you know or suspect you have endometriosis, go see an OBGYN and talk options. Don't just "put up with it." You do not need to suffer.
