Symptoms of endometriosis and how you can manage the pain
- Endometriosis is a chronic disorder that usually affects the pelvic cavity and can cause severe pain during sex and menstruation.
- Women are usually diagnosed in their 30s and 40s. And it most commonly occurs when tissue begins to grow outside the uterus, forming lesions that cause pain and inflammation.
- To treat endometriosis, medication, alone, can sometimes help. But if medication isn't enough, surgery to remove the lesions along with medication is also an option.
- This article was reviewed by Olivia P. Myrick, MD, who is a clinical assistant professor with the Department of Obstetrics and Gynecology at NYU Langone.
Endometriosis is a chronic disorder that usually affects the pelvic cavity and can cause severe pain during sex and menstruation.
It's common, affecting one out of every 10 women of reproductive age, or roughly 176 million women worldwide. Celebrities including Whoopi Goldberg, Daisy Ridley, and Julianne Hough have all had it.
Endometriosis is usually extra tissue on the outside of the uterus
Women are usually diagnosed in their 30s and 40s. And it most commonly occurs when tissue that's similar to the uterine lining, but not the same as, begins to grow outside the uterus, forming lesions that cause pain and inflammation.
However, lesions can also appear on your ovaries, fallopian tubes, and the lining of your pelvis. And in some cases, it can also affect your bladder, bowel, intestines, and rectum.
Symptoms of endometriosis
Endometriosis is a form of chronic inflammation that can cause scar tissue, or adhesions, to develop in the pelvis, which can be so painful to the point that they reduce your quality of life.
Painful periods, with severe cramping known as dysmenorrhea, and painful sexual intercourse are two very common symptoms of endometriosis. Other symptoms include:
- Heavy menstrual bleeding
- Excessive bleeding in between periods
- Chronic pelvic pain
- Painful ovulation
- Infertility in some cases
- Painful urination and bowel movements
- Read about more symptoms at the Mayo Clinic's website.
But too often, women put off seeking treatment for their symptoms. They do what's called "normalization" of their painful experience.
"They say, 'Oh, I'll put up with it,'" says Arnold Advincula, MD, chief of gynecology at NewYork-Presbyterian/Columbia University Irving Medical Center. "They accept it. But it's not normal to have extremely painful periods. It's not normal to have extremely painful intercourse."
Treatment for endometriosis
There's not a silver bullet when it comes to treating endometriosis. "It's not something that can be eliminated with one treatment," Advincula says. "It's a chronic disorder."
To start, it's important to seek a specialist and undergo a laparoscopy — a minimally invasive surgery that doctors use to diagnose and, sometimes, treat endometriosis.
After receiving an initial diagnosis, a doctor may prescribe medication. Medications typically include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen or ibuprofen for pain.
- Hormonal medications like Lupron, which can suppress the hormones that cause endometrial tissue to grow.
- A relatively new option called elagolix (brand name Orilissa) was approved in 2018 by the US FDA as a way to treat pain for endometriosis.
Some medications for endometriosis, like Lupron and Orilissa can come with potentially dangerous side effects, so it's important to discuss the side effects with your doctor before taking them.
When medicine, alone, isn't enough
Sometimes women don't respond well-enough to medication, or endometrial tissue or adhesions may develop in areas like the bowel, bladder, ureter, or other organs or parts of the pelvis, says Advincula. So, surgery to remove some of the tissue becomes the next best option.
"But it must be balanced with the medical side," he says. If you think you may be affected by endometriosis, Advincula strongly encourages you to call your doctor and make an appointment to be seen.
"We want to make sure that women get diagnosed as soon as possible," he says. "The earlier we are able to intervene, we are able to improve their quality of life."
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