Endometriosis, known by some as just “endo,” is a condition that has affected women worldwide for decades. It has gained visibility in the last couple of decades since the advent of the Internet, helping us to better educate and treat millions of women. The team at Memphis Obstetrics and Gynecological Association will be covering the symptoms, diagnosis, and treatment options for endometriosis.
Discerning Endometriosis Symptoms
One of the most frustrating aspects of this condition is how dramatically its painful symptoms can vary between women, making it notoriously difficult to diagnose. But there are still some common signs that almost always make an appearance in a positive diagnosis:
- Chronic Pelvic Pain: Persistent pain in the lower abdomen or pelvis, especially before and during menstrual periods, is one always of the most common symptoms.
- Painful Periods (Dysmenorrhea): Severe cramping that begins before your period and extends into your menstrual cycle is another hallmark of endometriosis. This is usually measured by being notably worse than that of friends or family members and possibly interfering with work or other daily activities.
- Pain During Intercourse: Many women with endometriosis experience discomfort or pain during or after sexual activity, sometimes to a point where it is too painful to engage at all.
- Pain with Bowel Movements or Urination: These symptoms often occur during menstruation and may indicate endometriosis that affects the bowel or bladder.
- Excessive Bleeding: Very heavy menstrual periods (menorrhagia) or bleeding between periods (menometrorrhagia) are also common signs.
- Infertility: Women having difficulty conceiving can be linked to endometriosis and might be one of the first indicators for some patients.
- Other Symptoms: Miscellaneous, unpleasant symptoms like fatigue, bloating, nausea, and diarrhea or constipation, particularly during menstrual periods, can also play a part in correctly diagnosing endometriosis.
When these symptoms are present and combined with one another, it’s usually a good indication that there’s a need for a discussion between you and your OBGYN.
A Challenging Diagnosis
For our providers at Memphis Obstetrics and Gynecological Association, the diagnostic process is an often meticulous, multi-layered one due to overlapping symptoms, as well as the presence of other conditions. Here are a few processes we use for diagnosis:
- Medical History and Symptom Discussion:
- Your provider will begin by reviewing your medical and family history and assessing your symptoms in detail. We’ll determine the severity of symptoms and build a timeline.
- Physical Examination:
- A pelvic exam may be performed to check for visible abnormalities, though endometriosis lesions are often too small to detect by eye.
- Imaging Tests:
- Ultrasound: Transvaginal or abdominal ultrasounds are useful for identifying cysts, which are often associated with endometriosis, such as endometriomas.
- MRI: Also known as magnetic resonance imaging, this imaging process provides us with extremely detailed internal images to help pinpoint areas of endometriosis.
- Laparoscopy:
- This modern, minimally invasive surgical procedure is considered the highest standard for diagnosing endometriosis. During a laparoscopy, we use a small camera inserted through a tiny incision to visualize and biopsy endometrial-like tissue.
- Blood Tests:
- Blood tests aren’t necessarily definitive in terms of a diagnosis, but they can help provide clarity by ruling out other conditions or indicating inflammation associated with endometriosis.
Treatment Options
Treatment can be complex and lengthy. Beyond the issue of pain management, a treatment solution will be carefully tailored based on factors like the extent of symptoms, age, and considerations about fertility.
- Hormonal Therapy
- Birth Control Pills:
- Oral contraceptives can help regulate or eliminate periods, thereby reducing the pain associated with endometriosis for some.
- Progestin Therapy:
- Progestin-only pills, injections, or intrauterine devices (IUDs) can also be used potentially to suppress menstruation.
- Gonadotropin-Releasing Hormone (GnRH) Agonists:
- These medications induce temporary menopause to reduce estrogen levels, shrinking endometrial growths.
- Birth Control Pills:
- Surgical Options
- Laparoscopic Surgery:
- Our providers use robotic surgery to remove or destroy endometriosis lesions while preserving healthy tissue.
- Hysterectomy:
- In the most extreme cases, removal of the uterus, and sometimes the ovaries, may be necessary—though this is typically a last resort.
- Laparoscopic Surgery:
- Lifestyle Changes and Complementary Therapies
- Dietary Adjustments:
- Anti-inflammatory dietary changes may be helpful. We would suggest building one from scratch or making adjustments that are rich in fruits, vegetables, whole grains, and omega-3 fatty acids, all of which can help manage symptoms naturally.
- Exercise:
- If a patient isn’t already physically active, exercise can be a game-changer. Regular physical activity can reduce endometriosis pain while improving overall well-being.
- Dietary Adjustments:
- Stress Management:
- Mental and physical techniques like yoga, meditation, therapy, or acupuncture may provide additional relief for some individuals.
A Holistic Solution
The challenges of endometriosis are both physical and mental. Having the support of your provider, our team, and your family and friends helps to make the unbearable bearable. Please reach out to your nearest office or current MOGA provider if you suspect you may be experiencing symptoms of endometriosis in East Memphis, Wolfchase, or DeSoto.