TriStar Portland - March 28, 2017

Endometriosis is one of the most common gynecological health conditions, affecting around 5 million women in the U.S. alone, according to the National Institutes of Health. But many women don’t even know they have it until they are trying to get pregnant.

Endometriosis is a condition that causes tissue to grow outside the uterus on the ovaries, fallopian tubes, bowels, bladder or behind the uterus. These growths or lesions can cause symptoms like abdominal pain, painful sex, heavy menstrual periods and infertility. Women in their 30s and 40s are most likely to be diagnosed.

While there isn’t a cure for endometriosis, there are treatment options that can help manage the pain and the heavy periods associated with it. Here’s what you need to know about endometriosis diagnosis and the treatment options available.

How is endometriosis diagnosed?

To determine whether or not you have endometriosis, your gynecologist will perform a pelvic exam. They’ll insert two fingers into your vagina, while pushing gently on the lower abdomen. A rectovaginal exam may also be done—your gynecologist will insert their index finger into the vagina and their middle finger into the rectum to feel for growths.

If the doctor finds anything abnormal, laparoscopy surgery, a procedure where tissue is removed for biopsy, will most likely be suggested.

If you are diagnosed with endometriosis after the surgery, current treatment options can reduce pain, stop your period flow and more.

Treatment Options

After your diagnosis, you’ll work with your gynecologist to determine the treatment options for you. Some factors that might affect your treatment options include:

  • Your age, especially if you are at or near the end of menopause
  • Whether or not you want to have kids
  • Severity of the condition and symptoms

Treatment for the most common endometriosis symptoms like pain, heavy periods and painful sex fall into three categories: pain medications, hormone therapy and surgery. Here’s how they break down:

  • Pain medications: For mild symptoms, your doctor may recommend over-the-counter pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDS) or opioids, prescription drugs that work with the nervous system.
  • Hormone therapy: Hormone treatments prevent the ovaries from producing hormones and, in turn, prevent ovulation. Halting ovulation will prevent the endometrial lesions and endometrium from growing. There are a variety of hormone therapies; here are the most common:
    • Birth control pills: Oral contraceptives regulate and lighten up your periods, and can also reduce pain.
    • Progesterone and progestin: Taken in the form of a pill, injection or Ie, this treatment stops a woman’s period completely or reduces its frequency.
    • Gonadotrophin-releasing hormone agonists: This treatment comes in nose spray and injection form, and will stop the production of hormones in order to prevent the endometriosis lesions from growing. This will prevent ovulation and menstruation, putting you in a “menopausal state.”
    • Danazol: Danazol is used to stop the hormones involved in the menstrual cycle from releasing. This treatment may damage a developing fetus, so it will not be recommended for those who are pregnant or trying to get pregnant.

If you have severe pain, your gynecologist may recommend surgery.

  • Surgical treatments: Surgery may relieve severe endometriosis pain for a certain period of time, but not forever. Surgeries allow your doctors to find the endometriosis lesions and remove them. The most common surgeries include:
    • Laparoscopy: A surgery that involves removing the lesion and the tissue above and below the surface by destroying them with intense heat, a process called cauterizing.
    • Laparotomy: This major surgery involves the removal of endometriosis patches, and is normally suggested as a last resort. Sometimes, this surgery also involves the removal of your uterus, called a hysterectomy. If the ovaries have lesions, they may be removed during the lap procedure, too.
    • Surgery to sever pelvic nerves: If you have pain in the center of the abdomen, cutting your pelvic nerves may help alleviate the pain.
You and your doctor will determine the treatment plan that’s right for you; often times it’s a combination of hormone therapy and surgery. And while there isn’t a cure for endometriosis, these treatment options can help you manage the symptoms and the pain.

This content is presented in collaboration with

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