Endometriosis is an often painful disorder in which tissue that normally lines the inside of the uterus – the endometrium – grows outside the uterus. Endometriosis usually involves the ovaries, bowel, or tissue lining the pelvis.
In endometriosis, the displaced endometrial tissue thickens, breaks down, and bleeds with each menstrual cycle, like the tissue is supposed to. But because it has no way to exit your body, the tissue becomes trapped. The surrounding tissue can become irritated, develop scar tissue, and bind with other organs.
This can cause pain – sometimes severe – especially during one's period. Fertility problems also may develop. Fortunately, effective treatments are available.
The most common symptom of endometriosis is pelvic pain, often during the menstrual period.
Other symptoms of endometriosis may include:
- Pain with sexual intercourse
- Pain with bowel movements or urination
- Excessive bleeding during your menstrual period
Treatment for endometriosis usually starts with medications. Surgery is used only as a last resort.
Over-the-counter pain relievers such as the nonsteroidal anti-inflammatory drugs ibuprofen (Advil, Motrin IB) and naproxen (Aleve) may help ease menstrual cramps.
If over-the-counter medication isn’t enough, supplemental hormones are sometimes prescribed. Birth control pills, patches, and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month.
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink.
Medroxyprogesterone (Depo-Provera) is an injectable drug that halts menstruation and the growth of endometrial implants, thereby relieving the symptoms of endometriosis. Side effects can include weight gain, decreased bone production, and depressed mood.
Danazol suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones. However, Danazol can cause serious side effects and be harmful to your baby if you become pregnant while taking this medication.
Surgery can remove as much endometriosis as possible while preserving the uterus and ovaries. The procedure may also increase a woman's chances of getting pregnant.
In severe cases of endometriosis, surgery may be needed to remove the uterus and cervix as well as both ovaries. This is typically considered a last-resort treatment.
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