Endometriosis

The lining of the uterus is called the endometrium. Sometimes, tissue like that which normally lines the inside of the uterus grows elsewhere in the body. When this happens it is called endometriosis.

What Is Endometriosis?
With endometriosis, tissue like the endometrium is found in other areas in the body. It looks and acts like tissue in the uterus.

Endometrial tissue may attach to organs in the pelvis or to the peritoneum. It also may be found in other parts of the body.

Endometrial tissue outside the uterus responds to changes in hormones. It also breaks down and bleeds like the lining of the uterus during the menstrual cycle. This bleeding can cause pain, especially before and during your period.

Who Is at Risk?
Endometriosis is most common in women in their 30s and 40s, but it can occur any time in women who menstruate. Endometriosis occurs more often in women who have never had children.

Symptoms
The main symptom of endometriosis is pelvic pain. Such pain may occur with sex, during bowel movements or urination, or just before or during your menstrual cycle.

No one is certain of the cause of endometriosis.

The amount of pain does not always tell you how severe your condition is.

Many women with endometriosis have no symptoms.

Diagnosis
Endometriosis can be mild, moderate or severe. The extent of the disease can be confirmed by looking directly inside the body. This can be done by laparoscopy.

Treatment
Treatment for endometriosis depends on the extent of the disease, your symptoms, and whether you want to have children.

Medications
In some cases of endometriosis, medications or NSAIDs (nonsteroidal antiinflammatory drugs) may be used to relieve pain. These drugs will not treat any other symptoms of endometriosis.

Hormones also may be used to relieve pain. Hormone treatment is designed to stop the ovaries from releasing hormones.

These medications are not for all women. As with most medications, there are some side effects linked to hormone treatment.

Oral contraceptives . Birth control pills often are prescribed to treat symptoms of endometriosis. The hormone in them helps keep the menstrual period regular, lighter and shorter and can relieve pain.

Gonadotropin-releasing hormone . GnRH is a hormone that helps control the menstrual cycle. GnRH agonists are drugs that are much like human GnRH but many times stronger than the natural substance. This causes a short-term condition that is much like menopause.

Progestin . The hormone progestin also can be used to shrink endometriosis. Progestin works against the effects of estrogen on the tissue.

Danazol . Danazol is another type of hormone that shrinks endometrial tissue. It lowers levels of estrogen and progesterone. It is taken as a pill for at least six months.

Surgery
Surgery may be done to remove endometriosis and the scarred tissue around it. In most severe cases of endometriosis, surgery often is the best choice for treatment. Healthy ovaries and normal fallopian tubes are left alone as often as possible.

Coping
Endometriosis is a long-term condition. Many women have symptoms that occur off and on until menopause. Keep in mind that there are treatment options. A woman can work with her doctor in making the right decision for her.

Finally …
Endometriosis can cause pain and infertility. It often can be treated with success. You may need more than one kind of treatment.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months.

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