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Endometriosis at UPMC in South Central Pa.

Pelvic pain and menstrual irregularities are often part of a woman’s life. When discomfort becomes constant and unbearable, endometriosis may be the cause. An estimated 10% to 15% of American women between the ages of 25 and 40 will develop this common — yet mostly unheard-of — disease. Too many suffer in silence, in part because people assume — incorrectly — that they exaggerate their pain.

What is endometriosis?

Endometriosis is a condition where cells, like those from the lining of the uterus, start growing on other organs. Endometriosis can cause very painful menses, lower back and abdominal pain, excessive bleeding, pain between periods, pain with intercourse, and result in infertility if not treated. The condition can develop during puberty or several years after the onset of menstruation or even after having children. It affects all races and economic classes.

There is no one clear cause, but genetics may be involved. If your mother or other first degree relative had endometriosis, you are six times more likely to have the disease. The abnormal cell growth is usually found on the ovaries, fallopian tubes, the ligaments supporting the uterus, and tissues lining the pelvis. Other locations for endometriosis include:

  • Vagina
  • Intestines
  • Rectum
  • Cervix
  • Bladder
  • Vulva
  • Abdominal surgery scars

Hormonal changes of the menstrual cycle affect the endometriosis tissue, causing the area to become inflamed and painful. While some may assume this is normal, it is not. Too often, women are not taken seriously and often dismissed as exaggeratory or having a low threshold for pain. It is important for lay people and the medical community to know that endometriosis is more than cramps. It interferes with a woman’s daily life. In fact, 38% experience a loss of productivity at work or school than those without the disease.

Am I at risk for endometriosis?

Medical professionals attribute endometriosis to many possible causes, but the classical theory is that is starts from retrograde menstruation where the blood flows back into the fallopian tubes and pelvic cavity instead out of the body. Risk factors for having endometriosis include:

  • First birth after age 30
  • Caucasian women
  • Starting your period at an early age
  • Going into menopause at an older age
  • Short menstrual cycles — less than 27 days between each
  • Heavy menstrual periods that last longer than seven days
  • Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
  • Low body mass index (BMI)
  • One or more relatives with endometriosis
  • Reproductive tract abnormalities
  • Continued pain despite birth control pills for 6 months

Aside from pain and frustration, around one-third to one-half of women diagnosed also have difficulty getting pregnant.

How is endometriosis diagnosed?

Sharing your symptoms with your provider is the first step toward diagnosing your condition. At that time, a woman’s primary care or ob-gyn provider will conduct pelvic exam, ultrasound, CT scan, or MRI scan. A normal test does not mean you don’t have endometriosis and doesn’t mean the pain isn’t real. Sometimes you need surgery to determine if endometriosis is present, but you don’t need surgery before you can begin treatment to relieve your pain.

What are my treatment options for endometriosis?

Women may benefit from any number of treatment options. Your doctor may offer standard treatment options that include nonnarcotic pain medications, hormone therapy, pelvic floor therapy, and surgery (excisional not ablative surgery) to decrease the amount of endometriosis present; however, there are other avenues for relief such as:

  • Heat therapy encourages blood flow. Hot compresses in the form of a heating pad or water bottle, a warm bath, or disposable hot packs all can ease pelvic pain.
  • A nutritious diet reduces inflammation, including vegetables, fruits, whole grains, and foods with omega-3 fatty acids like salmon, avocado, nuts, and olive oil.
  • Exercising at least 30 minutes each day helps lower levels of estrogen and inflammation, while boosting the feel-good chemicals known as endorphins.
  • Massage helps relax muscles and release tension.
  • Meditation, therapy and support groups can help mental health and address any stressors. Options include professional support and at-home meditation to calm the mind and body.
  • Over-the-counter anti-inflammatory drugs like naproxen sodium or ibuprofen temporarily relieve inflammation and pain.
  • Getting the recommended amount sleep is important in maintaining our overall well-being. Adults should get 7 to 9 hours each night
  • Socializing with people who bring joy can counter the depression and stress that accompany chronic or acute pain. If your quality of life is poor, it can erode your ability to cope with pain or any of life’s unexpected curves.

Although there is no cure for endometriosis, there is hope for an improved quality of life with treatment options and supportive care are available to manage symptoms. Once a woman reaches menopause, her symptoms may disappear. Until that time, however, women need to be their own advocate in finding relief – first by finding a provider who understands the disease.

Talk to your doctor about recommended lifestyle changes, medications, therapies, and possible surgical procedures depending upon your individual stage and severity of pain.

For more information about endometriosis or to schedule an appointment with one of our UPMC experts, visit UPMC southcentral PA.


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