Endometriosis awareness takes places during the month of March to raise awareness of the 200 million women worldwide impacted by the disease.
Nichole Mahnert, MD, co-director of the Minimally Invasive Gynecologic Surgery Fellowship at the University of Arizona College of Medicine – Phoenix and a practicing OBGYN at Banner – University Medical Center Phoenix, discusses the effects of endometriosis and answers frequently asked questions.
What is endometriosis?
Endometriosis is a hormonally mediated chronic inflammatory condition in which tissue from inside the uterus is found outside the uterus, most commonly on the uterus, ovaries and tissue lining the abdomen.
What are the most common symptoms?
Painful, heavy and irregular periods, pain with intercourse, infertility, and ovarian cysts.
How is endometriosis diagnosed?
The only way to truly diagnose endometriosis is through surgery with a biopsy that is examined by the pathologist. There is a lot we don’t know about endometriosis. For example, the stage of endometriosis does not correlate well with the amount of pain. A woman with Stage 1 endometriosis (very little) can have severe pain and a woman with Stage 4 endometriosis (most severe) may have no pelvic pain. It is important for providers to take a holistic approach to treatment, as women with endometriosis may also have other conditions and symptoms that are not cause by endometriosis, but nevertheless associated with endometriosis. The primary treatment for endometriosis is hormonal suppression of the menstrual cycle. There is also a role for surgical intervention, most commonly with laparoscopy for the diagnosis and treatment of endometriosis. Other treatments focus on treating pelvic pain associated with other organ systems such as the muscles, nerves, GI and urinary tract.
What are a few examples of conditions and symptoms that are not caused by endometriosis, but associated with it?
Among women who have endometriosis and chronic pelvic pain, the pelvic pain may be also can be related to the GI tract, pelvic floor and abdominal wall muscles, and the nerves. We know that women with endometriosis and pain also more commonly have other conditions such as migraines, fibromyalgia, IBS and interstitial cystitis.
As a patient who suspects they have endometriosis, are there steps they can take or information they can give their doctor that may help with a diagnosis?
It is always a great idea to track your symptoms so patients can discuss this with their doctor. For example, keep track of when the pain started, was it associated with any other events, life changes, injuries, etc. What makes the pain worse or better? Is the pain associated with GI or urinary symptoms?