Endometriosis is a chronic disease that usually worsens over time. It’s estimated that endometriosis occurs in up to 30 percent
of women.
The endometrium is the lining of the uterus that sheds each month during menstruation. The endometrium is lined with endometrial
cells. In women who develop endometriosis, these cells are also found in other areas of the body, most often in the pelvis,
where they attach themselves to the ovaries and fallopian tubes. Like endometrial cells found inside the uterus, those found
outside the uterus react to hormonal changes in the body. Each month during menstruation, they begin to swell and bleed.
The body responds to these abnormally placed endometrial cells by surrounding them with scar tissue. As the scar tissue increases,
women may develop severe pelvic pain, lower back pain, difficult bowel movements and irregular bleeding. Endometriosis can
also lead to infertility.
Treating Endometriosis
Endometriosis is treated two ways: with medication or with surgery. Women with mild symptoms of endometriosis may not require
treatment by a doctor. These women can often control pain by taking over-the-counter medications and using heating pads. Symptoms
will subside naturally following menopause. Until then, home treatments may provide enough relief for women with mild symptoms.
Women with moderate to severe symptoms that can’t be controlled through home treatment should consult a physician to learn
about other options. Prescription medications, including birth control pills, which are the most commonly prescribed medication
for this disease, can be used to relieve symptoms and stop the growth of endometriosis. Because this disease responds to hormones,
hormonal medications are often effective in treating it.
Laparoscopic surgery is used both to diagnose endometriosis and to treat it by removing lesions caused by scar tissue and
endometrial cells. During laparoscopic surgery, a surgeon makes a small incision (cut) and inserts a laparoscope -- a thin,
hollow tube with a light and magnifying lens on one end -- into the body so he or she can view the pelvic region. The surgeon
then uses surgical instruments to perform the procedure through the same or other small incisions.
In some cases of endometriosis, hysterectomy may be necessary. This procedure involves the surgical removal of the uterus
and possibly the ovaries and fallopian tubes as well.
The chosen treatment option depends on the severity of the symptoms and the woman’s situation. Women of childbearing age who
wish to have children may opt for pain medication or laparoscopic surgery, with hysterectomy only being used as a last resort.
If endometriosis has caused infertility, laparoscopic surgery may correct it.
David Jaspan, DO, has special expertise in performing minimally invasive gynecologic surgery.
Glossary of Terms:
Endometrium - The lining of the uterus that sheds each month during menstruation.
Fallopian tubes– Part of a woman’s reproductive system, these tubes transport eggs from the ovaries to the uterus.
Ovaries– Part of a woman’s reproductive system, the pair of glands that contain eggs.
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