Endometriosis is a very complex and often misunderstood medical condition that affects an estimated 10% of all women worldwide who are in their reproductive years. With endometriosis, tissue similar to the endometrial lining implants in various areas of the body though primarily in the pelvic region. More common locations for endometriosis lesions are the ovaries, fallopian tubes, peritoneum (pelvic side wall), outside of the uterus, cul-de-sac, bowel, bladder, rectum, appendix, ureters, and urterosacral ligaments. More rarely, other areas of the body can be affected from the vagina to the brain.
Most often, women with endometriosis complain of pain. While the pain can be cyclic, it can also occur throughout the month. Women with endometriosis may also have issues with pain during bowel movements (dyschezia), pain with intercourse (dyspareunia), pain with urination (dysuria), and pain before or during her menstrual cycle (dysmenorrhea). Pain from endometriosis can be mild to severe and the stage of endometriosis does not correlate with the severity of symptoms. Additionally, women with endometriosis can be asymptomatic.
Getting a Diagnosis
At this time, laparoscopy is the most definite way to diagnosis endometriosis. In general, endometriosis implants are too small to be seen on any type of imaging test and there are no blood tests to indicate its presence.
Keeping a symptom diary detailing your symptoms can help you and your doctor determine if a laparoscopy to diagnosis and possibly treat endometriosis would be appropriate.
Finding the Right Doctor
While many doctors know about and can to a degree treat endometriosis, it is critical that all women with this condition find the most knowledgeable and skilled surgeon she can. While currently there is no sub-specialty for endometriosis specialist, there are physicians who have taken a specialist interest in endometriosis and are thus considered an endometriosis specialist. They may be a gynecological surgeon, a reproductive endocrinologist, or maybe even a gynecological oncologist.
These specialists have extensive knowledge, training, and skills when it comes to treating this condition and often are able to offer higher success rates for their patients. They tend to be able to recognize more of the appearances of the implants, know where to look to find all of the implants, and use specialized surgical methods to more carefully eradicate the implants.
When interviewing a new doctor, the questions in this article may be helpful: What Questions Should I Ask?
Considering Your Treatment Options
The treatment options offered to you can depend on the skill and knowledge of your doctor and your specific symptoms. Your fertility concerns should also be taken into consideration. Treatment can range from pain medications to hormone therapy to surgery.
Pain medications can include over the counter pain medications, NSAID’s, or narcotics. These only treat the symptoms of endometriosis but do not treat the actual lesions.
Hormone therapy can include birth control pills, the Mirena IUD, GnRH-agonists, Danazol, or progesterone/progestin.
Surgical options include a laparoscopy for diagnosis and treatment, and in some cases a hysterectomy and/or oophorectomy though removal of the uterus and/or ovaries does not cure endometriosis.
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