Endometriosis is a condition that largely affects women in their childbearing years. Tissue that would normally grow inside the uterus as a part of the uterine lining, is found growing outside of the uterus. It usually isn’t dangerous or will even be noticed, but it can cause pain and other symptoms in some women.
The lining of the uterus is called the “endometrium.” Clumps of endometrium growing on the outside of the uterus are called “implants.” These are generally limited to organs of the reproductive system or other organs in the abdomen. Only very rarely do they spread outside of this area.
Normally, the endometrium thickens every month with the release of an egg into the uterus. If this egg isn’t fertilized, then the lining is shed during your monthly menstrual cycle.
The implants growing outside the uterus will do the same thing, thickening and then breaking down to be released during menses.
However, the implants are not able to be shed with the rest of the uterine lining. This can cause irritation, and at least sometimes that implants will create scarring and irritation on other reproductive organs. Occasionally, they will also cause cysts to form.
The causes of endometriosis are unknown. However, it is thought that it has something to do with an overabundance of estrogen.
Women in childbearing years often have large amounts of the hormone in their bodies. These are also the years when it is most likely that a woman will develop the condition. While this coincidence cannot be taken to prove the cause, it can be taken as a possible connection.
endometriosis pain symptoms
The symptoms of the condition are pain, abnormal bleeding during menses, and difficulty getting pregnant. Where you experience pain will depend on where your implants are growing.
You may have extreme cramping during menses, lower backache in the one or two days leading up to your period, or general pelvic pain.
The location of implants will also determine other aspects of pain. You may experience pain only during menses, during sex, during a bowel movement or only at ovulation.
There may also be significant issues with bleeding. Endometriosis can cause you to have extremely heavy periods, spotting between periods, bleeding after sex or in urine or stool. Again, this will depend on the location of your implants.
Finally, endometriosis can inhibit a woman’s ability to get pregnant. In fact, this may be the only symptom that some women will experience of the condition.
This will make an inability to conceive a mystery, since they haven’t experienced any of the other symptoms, leaving them without a clue that there’s anything wrong.
endometriosis pain treatment
There are at least two different routes taken for treatment depending on whether you’d like to relieve pain and bleeding, or whether you’re hoping to get pregnant. With the first, drugs and birth control are an option. For the latter, the only option may be surgery to remove the implants.
Again, depending on where the implants are, you will experience pain in different places. This can be in the rectum, vagina, lower back, abdomen or the legs.
Painkillers
Your first measure will often to take the over-the-counter painkillers that are in your house. Non-steroidal anti-inflammatory drugs are generally particularly effective because as well as pain relief, they also have anti-inflammatory abilities and can therefore help with bleeding as well.
Take the painkillers in regularly scheduled doses rather than just when the pain arrives. It will be more effective to have the drug circulating in your system, rather than waiting until the pain comes to take some.
If one NSAID is ineffective, then you can switch to a different brand or to acetaminophen like Tylenol.
Heat
Another measure you can take immediately is to apply heat to the area. This might be in the form of heating pads, but it might also be by taking a hot bath or shower and directing the water onto your affected areas.
Birth Control
If your pain is too severe for these simple measures, you can start taking birth control. These are hormonal in nature and will inhibit both your regular menstrual cycle and also the growth of implants. However, this is obviously not an option for women who are trying to get pregnant.
You can also start taking hormonal treatments directly. These are generally a stronger dose than is going to come in a birth control pill. Because they are stronger, they can also have more side effects.
The three main types used are gonadotropin-releasing hormone agonist, progestin and Danazol. All three lower estrogen levels and therefore help to relieve endometriosis pain. However, all three, and especially Danazol have significant side effects as well.
These will have the same effect as birth control, and they also will prevent you from getting pregnant.
Surgery
If these are also insufficient to relieve your suffering, there are some surgical options available. Laparoscopy can be used to reduce scarring and remove implants.
This is the insertion of a laparoscope into the abdomen through a very small incision. It is much less damaging than the full laparotomy that used to be the norm for any surgery on the abdomen.
Finally, as a last resort, it is possible that endometriosis will lead to a full hysterectomy. This is the removal of both the uterus and the ovaries.
Estrogen levels will immediately drop and so will your suffering from endometriosis. However, it is a fairly radical measure to take and will obviously not be an option if you are hoping to become pregnant.
It is advisable that if you are close to menopause, you try to manage your symptoms until hormonal changes take care of the condition for you. Menopause usually comes with a large drop in estrogen levels, and your endometriosis will be relieved simply by waiting.
Further Reading
“Endometriosis: Topic Overview.” WebMD. http://www.webmd.com/women/endometriosis/endometriosis-topic-overview.
“Pain Relief for Endometriosis.” endometriosis uk. http://endometriosis-uk.org/pain-relief-endometriosis.
“Endometriosis: No, severe pain is not ‘Normal’” Connections: An Educational Resource of Women’s International Pharmacy. http://www.womensinternational.com/connections/endometriosis.html.