Endometriosis is an inflammatory condition in which cells similar to those of the endometrium, the type of tissue that forms uterine lining, are found outside the uterus.
Implants mostly occur in the following places:
- Peritoneum;
- Ovaries;
- Fallopian tubes;
- Outer surfaces of the uterus, bladder, ureters, intestines, and rectum; and
- Cul-de-sac.
Additionally, many women with endometriosis have no symptoms. Women without symptoms often learn they have endometriosis when they cannot get pregnant or when they are having surgery for something else.
Endometriosis is characterized by non-menstrual pelvic pain as well as pain during menstruation. Endometriosis forms when the cells that normally line the uterus begin to grow outside of the uterus. These cells depend on a hormone called estrogen.
Endometriosis tissue grows and bleeds like the uterine lining does during the menstrual cycle. Tissue surrounding endometriosis tissue can become irritated, inflamed, and swollen.
The breakdown and bleeding of endometriosis tissue each month can also cause scar tissue to form. This scar tissue is called adhesions. Sometimes adhesions can cause organs to stick together making getting pregnant difficult. The bleeding, inflammation, and scarring can cause pain, especially before and during menstruation.
An obstetrician-gynecologist (OB-GYN) first may do a physical exam, including a pelvic exam, and order an ultrasound. An ultrasound can detect some kinds of endometriosis but may not detect other types.
The only way to certainly diagnose endometriosis is through a surgical procedure called laparoscopy. Access to ultrasound and laparoscopy are time-consuming and expensive processes.
At Afynia, we have developed EndomiR, the first-ever diagnostic blood test for endometriosis, shortening the delay from years to days.
Treatment options for endometriosis vary depending on the extent of the disease, your symptoms, medical history, treatment protocols, and whether you want to have children. Endometriosis may be treated with medication, surgery, or both. When pain is the primary problem, medication is usually tried first.
Pain management
Hormonal therapy
Surgery
Gonadotropin-releasing
hormone antagonist
Almost 4 in 10 females with infertility have endometriosis.
Inflammation caused by endometriosis may damage the sperm, the egg, or interfere with their movement through the fallopian tubes and uterus. In severe cases of endometriosis, the fallopian tubes may be blocked by scar tissue (adhesions).
What medications are used to treat endometriosis?
Medications that are used to help manage endometriosis symptoms include pain relievers, such asnonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal medications, including birth control pills, progestin-only medications, and gonadotropin-releasing hormone (GnRH) agonists. Hormonal medications help slow the growth of the endometrial tissue and may keep new adhesions from forming. These drugs typically do not get rid of endometriosis tissue that is already there.
How can surgery treat endometriosis?
Surgery helps remove endometriosis tissue. Removing this tissue may relieve pain and improve fertility.
Does surgery cure endometriosis?
After surgery, most women have relief from pain. But there is a chance the pain will come back. Up to 8 in 10 women have pain again within 2 years of surgery. This may be due to endometriosis that was not visible or could not be removed at the time of surgery. The more severe the disease, the more likely it is to return. Taking birth control pills or other medications after having surgery may help extend the pain-free period.
What if I still have severe pain that does not go away even after I have had treatment?
If pain is severe and does not go away, then discussion of your symptoms with your physician is warranted in a timely manner.