Endometriosis: Rogue tissue, pain and infertility

Endometriosis is a hard-to-diagnose and unpredictable disease. Some women with mild cases experience extreme pain. Some women won’t have any symptoms until their case is widespread and severe. And one woman who has endometriosis may not respond at all to a treatment that works miracles for the next woman in line. Early diagnosis and treatment are critical to prevent the spread of the disease beyond the pelvic organs and to preserve fertility.

What is endometriosis?

Endometriosis occurs when tissues that normally line the uterus find their way outside the uterus. Once they are in the pelvic area, they attach to other pelvic surfaces and organs — ovaries, fallopian tubes, the tissue lining your pelvis, etc. – and continue to grow. Not only do the tissues latch on to other organs, they continue to react to the cues of the menstrual cycle each month, thickening, breaking down and bleeding. Because other organs and tissues have no way for the degraded endometrial lining to escape the body, it becomes trapped causing painful cysts, irritation, adhesions and scarring. Pelvic tissues and organs can become painfully bound to each other. In some cases, the endometrial cells and tissue travel even further up into the body causing more damage and pain.

Symptoms of endometriosis

The first sign of endometriosis is usually pelvic pain that may occur daily and then worsen during your period. And the pain only becomes more intense each month as time goes on.

Other symptoms of endometriosis can include:

  • Painful intercourse
  • Painful urination or bowel movements
  • Excessive bleeding during periods
  • Bleeding between periods
  • Fatigue
  • Diarrhea or constipation
  • Bloating
  • Nausea
  • Infertility affecting up to 50% of women
  • Elevated risk of ovarian cancer

Because it can manifest in so many ways, endometriosis is often mistaken for other conditions that cause severe pelvic pain, such as ovarian cysts or pelvic inflammatory disease. Digestive symptoms also mean it can be misdiagnosed as irritable bowel syndrome. To diagnose endometriosis, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs. Tests to check for endometriosis include a pelvic exam, ultrasound and possible laparoscopy and biopsy for a definite diagnosis.

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Risk factors for endometriosis

Several factors place you at higher risk of developing endometriosis, many of which are related to more prolonged exposure to high estrogen levels and fluctuations, i.e., beginning your period at an early age, going through menopause at an atypically older age and short menstrual cycles. Women who have never given birth are also at higher risk.

Other risk factors include:

  • Low body mass index
  • Alcohol consumption
  • Family members who have endometriosis
  • Uterine abnormalities
  • Reproductive medical issues that prevent the normal menstrual flow out of the body

Treating endometriosis

Some women can manage their symptoms with over-the-counter pain medications. But as time goes on and symptoms worsen, many seek out more permanent relief.

Hormone therapy

Leveling out hormones can stop rogue endometrial tissue from thickening and degrading every month, easing pain and lessening the chance of complications. Hormone supplements can slow endometrial tissue growth and prevent new implantations outside the uterus. However, symptoms will likely return if treatment is discontinued. Some women find that symptoms disappear during pregnancy and end permanently with menopause if they forgo estrogen replacement therapy.

Conservative surgery

Women of childbearing age who are considering having children post-treatment are candidates for conservative surgery, which removes endometrial tissue from exterior surfaces of the reproductive organs to improve fertility. The procedure can be done laparoscopically to protect the uterus and ovaries. Eventually, however, the tissue is likely to re-grow, and the symptoms will return.

Endometrial ablation

This minimally invasive procedure removes the endometrium which can help ease some symptoms of endometriosis. It is used to help treat heavy menstrual flow.


In the most severe cases of endometriosis, the only sure solution is surgery to remove the uterus, cervix and ovaries. Because it will induce menopause, the long-term health risks following hysterectomy can include an increased risk of cardiovascular diseases and other menopausal health issues.

If you suspect you have endometriosis, early diagnosis and a treatment program can help prevent your condition from worsening over time. Call Integrative Wellness to set up an appointment with our compassionate staff, and we’ll help you get on the road to a more pain-free life.