ENDOMETRIOSIS

Endometriosis is a condition that can cause pain in the lower part of the belly and trouble getting pregnant.
The “endometrium” is the name for the inner lining of the uterus. In people with endometriosis, cells like those normally found in the endometrium grow outside of the uterus (figure 1). It is not known exactly how or why this happens. But when endometriosis cells grow, it causes inflammation inside the body. This can lead to symptoms.

Some people with endometriosis have no symptoms. But most have pain in the lower part of the belly that can occur:

• Before or during monthly periods
• Between monthly periods
• During or after sex
• When urinating or having a bowel movement (often during monthly periods)

Other symptoms of endometriosis can include:

• Trouble getting pregnant
• Growths on the ovaries that a doctor can feel during an exam

All of these symptoms can also be caused by conditions that are not endometriosis. But if you have any of these symptoms, tell your doctor or nurse.

No. But your doctor or nurse might suspect you have it by learning about your symptoms and doing an exam.

The only way to know for sure if you have endometriosis is for a doctor to do surgery and look for endometriosis tissue outside the uterus.

Endometriosis can be treated in different ways. The right treatment for you will depend on your symptoms and on whether you want to be able to get pregnant in the future.

Doctors can use medicines to treat endometriosis. These include:

• Pain medicines – Doctors often recommend “NSAID” medicines to treat the pain caused by endometriosis. These medicines, such as ibuprofen (sample brand names: Advil, Motrin), are available over-the-counter or by prescription. But these medicines do not make the endometriosis go away.
• Birth control medicines – Certain birth control medicines can help reduce pain symptoms. Options include oral pills, skin patches, vaginal rings, intrauterine devices (IUDs), implants, and injections. These treatments are not appropriate if you are trying to get pregnant.
• Medicines that stop monthly periods – These medicines stop the body from producing certain hormones. They can be helpful if birth control medicines do not relieve symptoms. For people who need to take them for longer than 6 months, doctors add treatment with other hormones.

Some people choose to have surgery to treat endometriosis. Different types of surgery can include:

• Laparoscopy – In this type of surgery, a doctor will make a small cut in the belly and put a tube with a camera inside the body. Then they can see and remove endometriosis tissue.
• Hysterectomy – If no other treatments work, doctors might suggest a hysterectomy. This is surgery to remove the uterus. Hysterectomy is typically only done if nothing else has helped. Sometimes, the doctor will also remove the ovaries and tubes that connect the ovaries to the uterus (fallopian tubes). It is not possible to get pregnant after your uterus is removed.

If you are having trouble getting pregnant, talk with your doctor or nurse. There are different medicines and treatments that can help.