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  • Writer's pictureGynecology Pelvic Surgery

Understanding Endometriosis


What is endometriosis?

Endometriosis is a chronic condition that causes discomfort throughout the abdomen and pelvis. It occurs when endometrial tissue, or tissue which lines the uterus, is implanted in regions located outside the uterus. The tissue is usually found in the fallopian tubes, ovaries, outer surface of the uterus, ligaments that support the uterus, and lining of the pelvic cavity. Endometriotic implants can be also found growing on the cervix, vulva, bladder, vagina, and bowel as well as within abdominal surgical scars in some instances. This tissue grows into lesions that respond to the woman’s menstrual cycle. This means that each month the endometriosis builds up, breaks down, and is shed. This tissue has no way of exiting the body like that in the uterus during a menstrual cycle. As a result, it may lead to the accumulation of blood within the ovaries creating endometriomas, also called "chocolate cysts". Also, it may lead to internal bleeding, inflammation, and pain. Because of chronic inflammation. endometriosis frequently leads to the creation of adhesions within the abdominal cavity or pelvis, bowel problems, infertility, and the formation of scar tissue. In more advanced stages of the disease, a "frozen pelvis" may develop that is associated with severe pain specifically during menstrual cycles.

Symptoms of Endometriosis:

  • Chronic pain, especially during the menstrual cycle

  • Pain with intercourse

  • Painful urination or painful bowel movements during menstruation

  • Gastrointestinal upsets such as nausea

  • Excessive pain before and during menstruation

  • Infertility

  • Fatigue

Treatment options:

  • Pain medications: Over-the-counter pain medications such as NSAIDs (Ibuprofen)

  • Hormonal therapy: (Oral contraceptive pills ("OCP"), hormonal patches, or hormonal intrauterine devices (Mirena, Skyla, Kyleena).

  • Progestin therapy: Progestin-only oral contraceptive pills or Depo Provera injections.

  • Gonadotropin-releasing hormones (GnRH) agonists.

  • Gonadotropin-releasing hormones (GnRH) antagonist; Elagolist (Orlissa) that suppresses hormones stimulating the growth of endometriosis.

  • Minimally invasive surgery including laparoscopic or robotic ablation of endometriotic lesions, or resection of ovarian endometriomas.

  • Hysterectomy in extreme cases is a last resort.

If you have symptoms related to endometriosis, please contact us.


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