The 101 on Endometriosis

The unveiling of Orlissa, an FDA-approved, first-of-its-kind oral medication for women dealing with endometriosis, has drawn a wave of attention to the disorder. This begs the question: What is endometriosis anyway?

What Is Endometriosis?

According to Dr. Sawsan As-Sanie, a gynecological surgeon at Michigan Medicine’s Von Voigtlander Women’s Hospital, endometriosis develops when “the tissue that normally looks like it should be on the inside of the uterus develops on the outside.” Endometriosis affects areas like the ovaries, fallopian tubes, and related organs in the pelvic area.

What Are the Symptoms?

Simply put, pain. Many women with endometriosis will have painful periods, pain with intercourse, gastrointestinal pain, or lower back pain. Roughly 10 percent, according to As-Sanie, have no symptoms at all. Oftentimes, women will be diagnosed with endometriosis when they are having trouble getting pregnant. “Of those who are infertile, roughly 30 percent have endometriosis,” As-Sanie says. “Some of the theories are scar tissue and adhesions around the ovaries and fallopian tubes, molecular changes, and challenges with implantation.”

How Is Endometriosis Diagnosed?

The only surefire way to diagnose endometriosis is with laparoscopic surgery, but doctors can usually make an educated guess well before that. “Diagnosis is often off symptoms alone,” says Susan Khalil, M.D., an assistant professor of obstetrics, gynecology, and reproductive science at Mount Sinai Health System in New York City. Women with particularly painful periods may already be on their doctor’s radar. 

How Is it Treated?

Endometriosis treatment depends on your needs at a given time. “There are many options, from medications to injections, or even surgery in some cases,” Khalil says. If you’re not trying to get pregnant, a hormonal birth control pill or intrauterine device might be a great option to relieve symptoms. Injections are often prescribed for those who want to increase their chances of pregnancy. Surgery is often required in cases of severe symptoms or problems with fertility. Endometriosis may cause cysts on the ovaries, and a gynecological surgeon can find and remove the lesions. 

How Can You Find Relief at Home?

As-Sanie says there are many ways to manage the chronic pelvic pain of endometriosis, and both non-pharmacologic and self-care routines can be helpful. “Things like yoga, aerobic exercise, cognitive behavioral therapy, acupuncture, and acupressure can all be explored with the patient’s care team,” she says. Many women who have endometriosis symptoms also suffer from other chronic conditions, like irritable bowel syndrome, interstitial cystitis, myofascial pain syndrome, and more, the sum of which need a “holistic approach” to treatment.

The Bottom Line

Just don’t wait out the signs of a growing problem or think chronic pelvic pain and severe menstrual pain is normal. “Some degree of persistent daily pelvic pain or very painful periods deserves evaluation, especially if pain relievers like ibuprofen are not working or the symptoms are interfering with your daily activities,” As-Sanie says. There’s no need to suffer when there are countless treatment options.