Potentially painful and, in many cases, a barrier to getting pregnant, endometriosis affects around 10 percent of women of childbearing age, according to the American College of Obstetricians and Gynecologists. This condition occurs when tissue resembling the lining of the uterus grows in other parts of the body and can be difficult to recognize, even for physicians, which can lead to lengthy diagnosis delays.

During Endometriosis Awareness Month in March, take time to learn more about this common condition. The more you know, the more empowered you’ll be to prioritize your health and seek answers if you experience endometriosis-like symptoms. 

Endometriosis, Defined

Simply put, endometriosis occurs when abnormal, uterine lining-like tissue appears where it shouldn’t. This tissue can form on the ovaries, fallopian tubes, and other parts of the reproductive system and beyond. Endometriosis growths can enlarge and bleed, leading to pelvic pain and other symptoms.

Women in their 30s and 40s are most likely to develop endometriosis. A common cause of infertility, endometriosis doesn’t necessarily prevent pregnancy but can make it more difficult. If you’re struggling to conceive, a fertility assessment with your OBGYN and fertility testing can help you better understand the problem and how to move forward.

A Genetic Connection?

The reason endometriosis develops isn’t clear, but several factors can increase your risk, including:

• Family history of endometriosis

• Having not had children

• Having started your period before age 11

• Heavy periods lasting longer than seven days

• Monthly menstrual cycles lasting less than 27 days

As researchers investigate possible causes of endometriosis, genetics may hold clues. Interestingly, in a large 2023 study, researchers at the University of Oxford found endometriosis may share genetic roots with certain pain and inflammatory conditions, including migraine and osteoarthritis. This finding may lead to new treatment options for endometriosis.

What a Pain

Endometriosis doesn’t always cause symptoms, but for many women, it is, quite literally, a pain. This pain may take the form of intense menstrual cramps, discomfort during sex, or pain in the back, pelvis or abdomen.

In addition to pain, endometriosis may cause:

• Digestive problems, such as diarrhea or constipation

• Discomfort when urinating or having a bowel movement

• Fatigue

• Spotting or bleeding when you’re not on your period

Diagnostic Dilemma

What makes endometriosis difficult to pinpoint? Researchers in the United Kingdom found that distinguishing between endometriosis symptoms and the symptoms of menstruation can be tough, but that’s not the only challenge. Factors ranging from the stigma surrounding menstrual pain to delayed referrals to specialists, among others, also contribute, the researchers concluded. As a result, many women wait years before receiving an endometriosis diagnosis.

You may be nervous about discussing endometriosis-like symptoms with your OBGYN, but remember, they deal with sensitive issues—and help patients solve complex health challenges—all the time. The sooner you understand what’s causing your symptoms, the sooner you can start treating them. Just be open, describe your symptoms with as much detail as possible and don’t leave any questions unasked. You can always seek a second opinion if you need to.

Soothing Symptoms and Aiding Fertility 

Only laparoscopic surgery—a minimally invasive procedure in which a surgeon uses a camera-tipped tube to look for endometriosis growths—can definitively diagnose endometriosis. Other diagnostic methods may also point to the condition. These include MRI or ultrasound or reduced pain after taking hormonal medications.

A cure for endometriosis doesn’t exist, so the goal of treatment is to reduce pain and other symptoms and, if you want to have a baby, improve fertility. Your treatment plan will likely start with medication: hormonal birth control if pregnancy isn’t part of your plans, or a gonadotropin-releasing hormone agonist if you’re hoping to conceive. Both types of medication can slow the pace of endometriosis progression.

Over-the-counter nonsteroidal anti-inflammatory medications may help reduce pain. Along with taking medications, you can follow helpful tips for living with endometriosis, such as eating more fruits and vegetables and practicing good sleep hygiene. These changes may help improve your symptoms.

Taking medications and changing habits may not work for everyone with endometriosis. If your symptoms don’t improve, surgery to remove the abnormal tissue may be right for you. 

Find an OBGYN at St. Luke’s Health.