Endometriosis

What Is Endometriosis?

Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus. It affects approximately 10% of women of reproductive age and is a leading cause of chronic pelvic pain. Diagnosis often takes years, and the condition can significantly impact quality of life.¹

Symptoms²

Pain Symptoms

Painful periods (dysmenorrhea)
Chronic pelvic pain
Pain during or after sex
Painful bowel movements
Painful urination during periods
Lower back pain

Other Symptoms

Heavy periods
Infertility
Fatigue
Bloating ("endo belly")
Nausea
Bowel or bladder symptoms

Diagnosis Challenges

Average 7-10 years to diagnosis
Often dismissed as "normal" pain
Symptoms vary widely
Definitive diagnosis requires surgery
Imaging may not show lesions

Diagnostic Process³

Detailed history and exam
Pelvic ultrasound
MRI in some cases
Laparoscopy (gold standard)
Trial of treatment sometimes used

Treatment Options

Pain Management

NSAIDs
Heat therapy
Physical therapy
Nerve blocks in some cases

Hormonal Treatments

Birth control pills (continuous)
Progestins
GnRH agonists
GnRH antagonists (newer)
Aromatase inhibitors

Surgery

Laparoscopic excision (preferred)
Ablation of lesions
Hysterectomy (last resort)
Excision by specialist often best

Comprehensive Care

Multidisciplinary approach helpful
Pelvic floor physical therapy
Mental health support
Dietary modifications (some benefit)
Complementary therapies

Living with Endometriosis

Track symptoms and cycles
Find a knowledgeable provider
Advocate for yourself
Connect with support groups
Manage stress
Communicate with partners

References

Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020;382(13):1244-1256.
Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354.e1-354.e12.
Giudice LC. Clinical practice: endometriosis. N Engl J Med. 2010;362(25):2389-2398.