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Endometriosis

Take the endo quiz 
 
If 1 or more of these statements are you...you may have endo.
1. Without pain medication, my period pain prevents me from going about my normal daily activities.
2. My period pain can make me nauseous or cause me to vomit.
3. I avoid sex because of pain.
4. I often have pain with bowel movements, especially before and during my period.
5. I experience pain between my periods that restricts my activities.
 

Laying Down

Top things to know

  • Endometriosis is a disorder where cells from the lining of your womb (uterus) grow in other areas of your body. This can cause pain, heavy bleeding, bleeding between periods, and problems getting pregnant (infertility).

  • Research suggests that 10 to 15 percent of women in their reproductive years have endometriosis.

  • Endometriosis is a leading cause of pelvic pain and painful sex

  • Until endometriosis is better understood, only the symptoms can be treated, and not the underlying causes

  • Management options include medications, surgery, and possibly lifestyle changes

 

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Causes

The cause of endometriosis is not clear. 

 

One idea is that when you get your period, the cells may travel backward through the fallopian tubes into the pelvis. Once there, the cells attach and grow. However, this backward period flow occurs in many women. The immune system may play a role in causing endometriosis in women with the condition.

 

Whoopi Goldberg had endo. At the Endometriosis Foundation’s Blossom Ball in 2009, Goldberg said, “There is nothing dirty about it. No religious group is going to be pissed if you discuss this. Because if you don’t discuss it, many more women are going to find themselves unable to have children, or find themselves close to dying because [the disease has] led to something else.”

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Symptoms

  • Painful periods.  

  • Pain with sex

  • Pain with urination.

  • Pain with bowel movements.

  • Back pain.

  • Heavy periods.

  • Bleeding in between periods.

  • Infertility (difficulty getting pregnant).

  • Fatigue.

  • Diarrhea, nausea, constipation, and bloating.  

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Exams and Tests

You may have one of these tests to help diagnose the disease:

 

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Create Your Endometriosis Team

To manage endo, you will need to assemble a team of experts.  

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Acupuncturist  

To help manage pain symptoms. Check out Scarsdale Acupuncture.

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Massage Therapist

A massage therapist who can work on adhesions is also highly beneficial. Katie DiChiaro is great, located in Somers. 

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Mental and Emotional Support

 Women with chronic pain often also suffer from depression and anxiety. 

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Pelvic Floor Physical Therapist 

Having a physical therapist can be highly beneficial when dealing with endo. I refer my patients to Hudson Valley Physical Therapy in Hartsdale. 

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Registered Dietitian

 A registered dietitian will help design the best diet for you. 

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Specialized Surgeon

Some women with endometriosis need to have surgery.

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Treatment

PAIN RELIEVERS

If you have mild symptoms, you may be able to manage cramping and pain with:

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  • Exercise and relaxation techniques.

  • Over-the-counter pain relievers -- These include ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol).

  • Prescription painkillers, if needed, for more severe pain.

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HORMONE THERAPY

for women not trying to get pregnant.

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Birth control pills -- Take the hormone pills (not the inactive or placebo pills) for 3 months continuously. 

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Progesterone pills, injections, IUD -- This treatment helps shrink endometriosis. Side effects may include weight gain and depression.

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Leuprolide injection (Lupron Depot) -- An injection that stops your ovaries from producing the hormone estrogen. This causes a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment is often limited to 6 months because it can weaken your bones.  

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Orilissa -- An oral medication helps lower the production of estrogen resulting in a menopausal-like state and controls the growth of endometrial tissue resulting in less severe pain and heavy menses. 

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Myfembree - Once-daily treatment for the management of moderate to severe pain associated with endometriosis.

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STUFF TO TRY AT HOME

Magnesium 

Magnesium can help reduce pain and cramping. BioEmblem is a quality supplement.

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Turmeric Boost

Turmeric is an anti-inflammatory that can also support healthy estrogen metabolism.

 

SURGERY

If you have severe pain that does not get better with other treatments.

  • Laparoscopy helps diagnose the disease and can also remove growths and scar tissue. Because only a tiny cut is made in your belly, you will heal faster than other types of surgery.

  • Laparotomy involves making a large incision (cut) in your belly to remove growths and scar tissue. This is major surgery, so healing takes longer.

  • Hysterectomy is surgery to remove your uterus, fallopian tubes, and ovaries. Having both your ovaries removed means entering menopause. You would only have this surgery if you have severe symptoms that did not get better with other treatments and do not want to have children in the future.

 

Endometriosis and Pregnancy

It may be harder to become pregnant with endometriosis. If this is the case, options include:

  • Fertility drugs

  • Surgery to remove scar tissue from the uterus

  • Intrauterine insemination (IUI)

  • Assisted reproductive technology with (IVF)

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Once you are pregnant, endo has been linked to a higher risk of tubal pregnancies, miscarriage, preterm birth, and higher c-section rates. 

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Outlook (Prognosis)

There is no cure for endometriosis. Hormone therapy can help relieve symptoms, but symptoms often return when therapy is stopped. Surgical treatment may help relieve symptoms for years. However, not all women with endometriosis are helped by these treatments.

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Once you enter menopause, endometriosis is unlikely to cause problems. 

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