Endometriosis is an inflammatory gynecologic disease where tissue that normally lines the uterus (womb) grows in places outside of the uterus—typically in the pelvis—where it does not belong. It can attach/grow on pelvic organs like the fallopian tubes and ovaries, and sometimes can grow on the intestines or bladder. Just like the lining of the uterus grows and bleeds (sheds) each month, the endometriosis tissue also grows and bleeds, but it is trapped in the pelvis, which can cause inflammation and scarring, leading to symptoms like pelvic pain, bloating, pain with intercourse, and/or infertility.
How common is endometriosis?
Endometriosis affects up to 1-in-10 women, with over 176 million women worldwide having a diagnosis of endometriosis. It is seen more commonly in women with progressively worsening pelvic pain/chronic pain, and in up to 50% of women with infertility. While it usually is thought of as a menstrual disease in women of reproductive age, it can also affect teenagers, patients who have not yet had a menstrual cycle (“period”), or even in patients who have had a hysterectomy and are postmenopausal. There is also growing research looking at how endometriosis has systemic affects that go beyond the pelvis. Endometriosis unfortunately is under-recognized, but endometriosis specialists are working on ways to increase awareness and help make the diagnosis earlier by shifting to a clinical diagnosis of endometriosis rather than relying only on a surgical diagnosis.
What are symptoms of endometriosis?
- Progressively worsening pelvic pain—especially during the time of menstruation— that is not responsive to nonsteroidal anti-inflammatory drugs
- Cyclic bowel, bladder pain—such as pain with bowel movements during the time of menstruation, pain with urination during the time of menstruation
- Pain with intercourse
- Chronic pelvic pain (especially when pelvic pain had previously been cyclic), non-menstrual pelvic pain
Risk factors for endometriosis
- Early age at time of menses/period start
- Menstrual cycle intervals of less than 26 days
- Menses lasting longer than 7 days
- Family member with endometriosis
Endometriosis can be present even in the absence of risk factors and recent research has found that endometriosis can go along with altered metabolism and mood disorders. Understanding the systemic nature of endometriosis can help explain the extensive symptoms seen in endometriosis, and ultimately help us recognize and diagnose the disease earlier. If you feel you may have endometriosis, don’t hesitate to schedule an appointment with one of our endometriosis specialists so that we can discuss your symptoms/concerns, conduct a physical exam, and discuss individualized treatment options for you.