Endometriosis Symptoms, Risks, and Treatments

Endometriosis is a common — sometimes painful — gynecologic condition in women. It can cause pelvic or back pain and fertility problems.

Endometriosis is more than cramps. It interferes with a woman's daily life.

For instance, women with the disease miss more days at work or school than those without.

Too often, doctors don't take women seriously or dismiss them as having a low threshold for pain.

At the UPMC Magee-Womens Endometriosis Center in central Pa., we listen to you. We know your symptoms are real, and we'll work with you on a treatment plan that meets your needs.

What Is Endometriosis?

Endometriosis is a condition where cells that line the womb start growing outside of it — mainly on the:

• Ovaries.
• Fallopian tubes.
• Ligaments that support the womb.
• Tissues that line the pelvis.

Endometriosis can also affect the:

• Vagina, cervix, or vulva.
• Intestines or rectum.
• Scars from abdominal surgery.

Hormone changes in the menstrual cycle cause the endometriosis tissue to become inflamed and painful.

Nearby areas also become sensitive to any source of inflammation.

This causes severe pain with:

• Constipation.
• Diarrhea.
• UTIs.
• A distended bladder.

What Causes Endometriosis?

There's no one clear cause of endometriosis. Doctors attribute it to many possible reasons.

The classic theory is that it starts from retrograde menstruation. This is where the blood flows back into the pelvis and fallopian tubes instead out of the body.

Another cause may involve your genes.

If your mother or other first-degree relative had endometriosis, you're six times more likely to have the disease.

For some, the condition can start during puberty. For others, it may be several years after starting their period or even having children before they have symptoms.

What Are the Symptoms of Endometriosis?

Endometriosis doesn't always cause symptoms, but when it does, they can range from mild to severe.

The most common symptom is pain.

Specific symptoms may include:

• Very painful periods.
• Heavy periods or bleeding between periods.
• Severe menstrual cramps.
• Pain between periods.
• Chronic pain in the lower back and pelvis.
• Rectal pain.
• Pain during or after sex.
• Vaginal bleeding after sex.
• Blood in the urine or stool.
• Infertility. Around one-third to one-half of women diagnosed also have trouble getting pregnant.

Symptoms are often most severe before and during your period.

Endometriosis symptoms during your period

During your period, you may be more likely to have symptoms such as:

• Painful bowel movements.
• Pain when peeing.
• Diarrhea.
• Constipation.
• Bloating.
• Nausea.

When Should I See a Doctor About My Endometriosis Symptoms?

Call your doctor right away if you have sudden, severe pelvic pain.

The first step to diagnosing and treating your condition is telling your doctor about your symptoms.

Talk to your doctor if:

• Your periods have become painful.
• Pain interferes with your daily life.
• You start to have pain during sex.
• You have pain when you pee, have blood in your pee, or can't control urine flow.
• You have blood in your stool, pain during bowel movements, or an unexplained change in your BMs.
• You're not able to become pregnant after trying for 12 months.

Am I At Risk for Endometriosis?

Endometriosis risk factors include:

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

How Do You Diagnose Endometriosis?

Your PCP or ob-gyn will conduct a pelvic exam. They may also order an ultrasound, CT scan, or MRI.

A normal test doesn't mean you don't have endometriosis and doesn't mean the pain isn't real.

Endometriosis doesn't routinely show up in exams or scans, but sometimes we get findings that suggest it.

Surgery is often how we confirm endometriosis. But you can start treatment to relieve your pain or other symptoms before surgery.

What Are My Treatment Options For Endometriosis?

There's no cure for endometriosis, but there is hope. The first step toward diagnosis and treatment is to share your symptoms with your doctor.

Any number of treatment options may help improve your quality of life.

At the UPMC Magee-Womens Endometriosis Center in central Pa., we'll work together to create a treatment plan designed for you.

These may include one or more of the following:

• Surgery: from diagnosis to complete excisional surgery. This option depends on your symptoms and reproductive goals.
• Medicine: hormonal suppression, anti-inflammatories, supplements, and other alternative treatments.
• Chronic conditions management: illnesses linked to endometriosis such as pelvic floor dysfunction, IBS, and other chronic diseases.
• Pain management: non-opioid-containing medicine and alternative methods to help ease pelvic pain.

Many women with endometriosis suffer symptoms up to — and sometimes beyond — menopause.

Our doctors know how this disease impacts your life and are here to help.

Make an Appointment at the UPMC Magee-Womens Endometriosis Center

To learn more or make an appointment with one of our UPMC endometriosis experts, call 717-988-8170.

Our Providers

• Andrea Benton, MD, FACOG
• Timothy Deimling, MD, MSc, FACOG
• Gerald Harkins, MD, MPT, FACOG

Our Locations

UPMC West Shore
2025 Technology Parkway, Suite 108
Mechanicsburg, PA 17050

300 Continental Drive
Elizabethtown, PA 17022

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