Endometriosis is one sneaky, underhanded illness. It slips up on you, often without your even knowing it, then hits you in the gut, potentially rendering you infertile; or if you’re lucky enough to catch it in time, incapacitated for a short period, and hopefully able to continue with your life and bear children. In my case, I was lucky; I lost an ovary, but was still able to have children. Not everyone is that fortunate. That’s why it’s important to catch it in its early stages.
Many women don’t even know they have endometriosis until it has ravaged their reproductive organs, often causing intense pain, and in some cases, removal of the ovaries and/or uterus. In my case, it was something I’d never heard of; I knew I was in a lot of pain and sensed I had some type of lump in my lower abdomen, but I was not familiar with the disease. It even fooled my doctor until he actually confronted it on the operating table. Of course, not as much was known about endometriosis or its treatment at that time.
Endometriosis affects approximately 2-10% of American women of childbearing age. It ranges from minimal to severe (Stage I-IV), with some women experiencing intense, debilitating pain and others having minor to no symptoms. The cause of endometriosis is the displacement of uterine tissue outside the uterus. It begins growing outside the uterine cavity and can affect the ovaries, bowel and tissues lining the pelvis, and sometimes to areas outside the pelvic region. When it wanders to an area outside the uterus, the tissue can attach itself to different organs and continue growing, causing painful symptoms.
The endometrium is the tissue inside the uterus which is expelled monthly during menstruation. This misplaced tissue can become inflamed or swollen, and if the tissue migrates to other organs, it can attach itself and result in scar tissue, the build-up of blood blisters and/or internal bleeding, or fibrous cysts. When symptoms present, it is important to obtain a definitive diagnosis with one or more of the following:
- Biopsy – microscopic tissue examination
- Ultrasound – an office procedure which utilizes sound waves to show an image of internal organs
- CT scan – more specific than an x-ray; uses a combination of x-ray/computer technology
- MRI – magnetic resonance imaging; produces a two-dimensional image of organs
Many of the symptoms manifest during the menstrual period, ranging from cramping and pain in the abdomen and back, pain during urination or bowel movements, pain during intercourse, fatigue and abnormally heavy menstrual flow. The pain can be almost unbearable and the effects after diagnosis and treatment sometimes life-altering. It is one of the major causes of infertility in women and, in extreme cases, can lead to removal of the ovaries and/or uterus. In my own case, removal of one ovary was indicated. At the time, I had one child, and luckily, I was able to have two more children after the surgery. Other women are not so fortunate. I know of one young girl who had to have all of her reproductive organs removed before the age of 30. That is why it is such a tricky disease; it affects women differently and can result in a variety of symptoms, diagnoses and treatments. It also can make conception difficult, after surgery or treatment. But if you are fortunate enough to conceive, pregnancy may help keep you from a recurrence of the disease. Early diagnosis, during Stage I or II, is of course the key.
If endometriosis is suspected, your doctor may recommend a laparoscopy, which is a minor surgical procedure which inserts a thin tube with a lens and a light to search for endometrial growths. A laparotomy may be further indicated, which is more extensive surgery to remove tissue which has adhered to other organs and to save healthy tissue. The most drastic option is, of course, a hysterectomy, which involves removal of the uterus, and possibly the ovaries. This is usually only necessary in severe cases.
Some physicians may opt to treat less critical cases with a combination of hormone therapy and homeopathic or nutritional treatment. But the most important factor is early diagnosis. I was fortunate enough to be diagnosed in time to avoid a hysterectomy and to be able to have two children after my surgery. I urge any woman between the ages of 25 and 40 who experiences one or more of the above symptoms to consult a physician if they suspect they may be suffering from endometriosis. There is always hope, and I am living proof that endometriosis does not have to ruin your life.
Johns Hopkins Health Library, “Endometriosis”, www.hopkinsmedicine.org/healthlibrary/conditions/gynecological_health/endometriosis
Mohamed, Abdul W. and Solan, Matthew, “Endometriosis”, Healthline, pub. July 25, 2012, http://www.healthline.com/health/endometriosis#Overview