Chances are you know someone suffering from endometriosis. This prevalent, painful condition affects 1 out of every 10 women during their menstruation years. Your odds are twice as high (1 in 5) if you have a mother, sister or daughter with the condition. And anyone that has a period is at risk, from teenagers to older women approaching menopause.
Endometriosis is one of the leading causes of pelvic pain and infertility in women, affecting an estimated 5 to 6 million women in North America alone. Some 30 to 50% of women with endometriosis are infertile – twice the rate of the general population. Other symptoms include painful periods, pain during or after sex, or cysts known as endometriomas. And yet there are some women who have endometriosis with no symptoms at all.
This chronic condition occurs when the tissue that lines the inside of a woman’s uterus, known as the endometrium, is found growing in places outside the uterus – for example, on the ovaries, fallopian tubes or bladder. In addition, endometriosis can affect not only areas in a women’s pelvis, such as the bowel, ureters and appendix, but also the diaphragm, lungs, and other areas of the body. Each month, this displaced tissue responds as it normally would during a woman’s menstrual cycle, thickening and shedding through bleeding. But because it has no way to exit the body, it becomes trapped and can irritate the organs and tissue it comes in contact with, causing severe pain as well as scarring, making it difficult to get pregnant.
How do you know if your pain or infertility is caused by endometriosis? If medications are prescribed and the pain goes away, endometriosis may be diagnosed – but keep in mind you’re only treating the symptoms, not the cause. A diagnosis might also come from an ultrasound that shows you have a cyst, or endometrioma, which are very common in women with endometriosis. The most definitive way to confirm endometriosis, however, is through a minimally invasive procedure called laparoscopy.
In laparoscopy, the surgeon uses a tiny scope and surgical instruments inserted through small incisions around your belly button to look for and remove endometrial tissue and scar tissue (called adhesions). A biopsy or tissue sample is evaluated by a pathologist to provide the diagnosis. With this one minimally invasive procedure, a woman can have her endometriosis diagnosed and treated at the same time.
As with all minimally invasive surgical procedures, the smaller incisions made with laparoscopy mean less pain, faster recovery, shorter hospital stays and faster return to work compared to traditional open surgery. The laparoscope also magnifies the area being treated and can view the back of a woman’s pelvis, enabling the surgeon to see endometrial tissue that might be missed by the naked eye. The recurrence rate of endometriosis is also lower when treated with laparoscopy and a woman is less likely to develop scar tissue or adhesions following the procedure.
While laparoscopy can be used to diagnose and treat most cases of endometriosis, even severe cases, there are some situations when a woman isn’t a candidate for minimally invasive procedures, such as when a woman will not tolerate anesthesia well.
In all cases, the focus should be on relieving the pain and improving fertility through the most conservative approach possible – starting first with medication before considering any surgical options.
If you are experiencing pelvic pain or if you have been diagnosed with endometriosis that is not responding to medications, discuss with your doctor what other options are available to you, including diagnostic laparoscopy and treatment of endometriosis.