An OB-GYN whose been treating endometriosis for years shuts down the most common myths about this debilitating condition
Nov 23, 2022, 22:09 IST
- Misinformation around endometriosis can make it difficult to get an accurate diagnosis.
- Dr. Sara Twogood discusses some of the most common misconceptions around endometriosis.
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Living with endometriosis can be extremely debilitating. The condition affects an estimated 200 million people worldwide and can cause intense periods, fertility issues, and painful sex — just to name a few of the condition's many symptoms.
Medical term: Endometriosis primarily affects females and occurs when tissue — similar to tissue that lines the uterus — grows outside the uterus. When this happens, it causes painful lesions that often appear on the ovaries, fallopian tubes, and pelvic lining but they can also be found on the bladder, bowel, intestines, and rectum.
While there is no cure for endometriosis, a diagnosis can help you find the right treatment method — like diet or birth control — to help you manage the pain. However, it can oftentimes be difficult to get a diagnosis because endometriosis is misunderstood among certain communities.
So to help combat misinformation around this condition and set the record straight, we spoke with Board Certified Obstetrician-Gynecologist Dr. Sara Twogood of Flo who sees and treats patients with endometriosis in her clinical practice.
Is endometriosis underdiagnosed?
Twogood: Yes. It can be underdiagnosed. This is mostly because it relies on a patient's history of her symptoms and often the severity of these symptoms are not taken seriously or dismissed as being normal or in the range of normal.Is endometriosis easy to diagnose?
Twogood: The most definitive diagnosis of endometriosis is made through a surgical procedure called a laparoscopy which involves anesthesia. However, many doctors — myself included — provide a presumptive diagnosis without recommending a laparoscopy for confirmation. This is because endometriosis symptoms overlap with many other conditions and doctors can help manage those symptoms in similar ways. So, in the end, even if the endometriosis diagnosis is not correct, we still get the benefit of helping the symptoms without the risks that come with a surgical procedure.Some conditions that overlap with endometriosis are PMS, fibroids, PID, ovarian cysts, IBS and other bowel disorders, hemorrhoids, tenesmus, interstitial cystitis, chronic UTIs … so lots!It is also possible for people to be diagnosed with endometriosis through surgery for other indications such as someone having surgery for appendicitis, or gallbladder surgery, or a c-section, or ovarian cyst, or sterilization. These surgeries may reveal the endometriosis implants even when there were no other known symptoms present.Is endometriosis painful for everyone?
Twogood: About one-third of women with endometriosis are asymptomatic, meaning they experience no symptoms of pain, or otherwise. Symptoms of endometriosis can vary but they often reflect the area of implantation but not always. Such symptoms may include the following:- Dysmenorrhea (painful periods)
- Heavy or irregular bleeding
- Pelvic pain
- Lower abdominal or back pain
- Dyspareunia (painful sex)
- Dyschezia (pain on defecation) often with cycles of diarrhea and constipation
- Bloating, nausea, and vomiting
- Perineal pain
- Pain during urination or blood in the urine
- Pain during exercise
Does endometriosis make me infertile?
Twogood: It's important to note that endometriosis is considered to be one of the three major causes of female infertility, and 30% to 50% of women with endometriosis may experience infertility.The condition can influence fertility in many potential ways:- distorted anatomy of the pelvis
- adhesions
- scarred fallopian tubes
- inflammation of the pelvic structures
- altered immune system functioning
- changes in the hormonal environment of the eggs
- impaired implantation of a pregnancy
- altered follicle and egg quality
Will menopause make my endometriosis less severe?
Twogood: For some women, the painful symptoms of endometriosis improve after menopause. As the body stops making the hormone estrogen, the growths shrink slowly. However, some women who take menopausal hormone therapy may still have symptoms of endometriosis or endometriosis can even be reactivated by menopausal hormone therapy.Can endometriosis be prevented?
Twogood: No one knows for sure what causes this condition. That is why we don't know how to prevent it. While any woman can develop endometriosis, the following groups seem to be at a higher risk:- Family history of endometriosis
- Delayed childbirth (women aged 30+ giving birth for the first time)
- Starting period at an early age (people who begin menstruating before the age of 11 may be at a higher risk)
- Short menstrual cycles (< 27 d)
- Long duration of menstrual flow (>7 d)
- Heavy bleeding during menses
- Any medical condition that prevents the passage of blood from the body during menstrual periods such as cervical stenosis, cervical scarring, hymen anomalies, uterine anatomic anomalies, etc.
- Low body mass index: This risk factor is based on observational studies where people with a lower BMI were statistically more likely to have endometriosis compared to those with a higher BMI.