What You Should Know about Endometriosis

Symptoms, Diagnosis and Treatment

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If you have painful periods and pelvic pain, endometriosis may be to blame. Endometriosis is a type of women's pelvic pain that affects 5 percent to 10 percent of females. Here's what you should know about the condition, including symptoms, diagnosis and treatment options.

What Is Endometriosis?

In women with endometriosis, tissue from the endometrium, which lines the uterus, grows outside the uterus.

This tissue may be found in the pelvic cavity, around the ovaries, behind the uterus or even in the bladder or bowel. This extra tissue causes an inflammatory response that can cause scarring and adhesions to form in the pelvic cavity. Endometriosis is one of the most common types of chronic pelvic pain in women.

Symptoms of Endometriosis

The most common endometriosis symptom is dysmenorrhea or a painful menstrual period. Endometriosis pain is usually located in the pelvic region, though it can occur in the lower back as well. Endometriosis pain may occur before, during or after menstruation. It may also cause pain during sexual intercourse, bowel movements, and urination. Other symptoms of endometriosis include bowel disorders and fatigue. Some cases of endometriosis can cause infertility.

Diagnosing Endometriosis

If your doctor suspects you have endometriosis, he or she may perform any of the following diagnostic tests:

  • Pelvic exam: much like you would have at your usual gynecologist checkup.
  • Transvaginal ultrasoundAn ultrasound provides a picture of what is happening in and around your uterus, and can help locate nodules and cysts.
  • MRI: If a clearer picture of the tissues in and around the pelvic cavity is needed, MRIs can provide more detailed imaging.
  • LaparoscopyDuring a laparoscopy, your doctor inserts a small camera through a tiny incision in your abdomen to examine structures in the pelvis. A sample of tissue for a biopsy can also be taken.

Treating Endometriosis

Fortunately, the medications and treatments available for endometriosis are effective at getting most cases under control. Typical treatments for endometriosis include:

  • Painkillers: Over-the-counter or prescription NSAIDs can control pain in mild cases.
  • Hormone treatments: Progesterone, oral contraceptives and gonadotropin agonist drugs — which keep the ovaries from producing estrogen — can control mild endometriosis pain. They may be combined with NSAIDs.
  • Laparoscopic surgery: For severe endometriosis pain, this minimally invasive surgery can remove the excess endometrium or scar tissue.

A combination of these approaches is often used, and research indicates that they can relieve endometriosis pain in up to 75 percent to 80 percent of cases. Unfortunately, that means around 20 percent of women with endometriosis may require more aggressive intervention, and some may not be cured.

Mild to moderate endometriosis cases seem to have the greatest success rates.

In the most severe cases, nerve removal or a hysterectomy may be performed to control endometriosis pain, though these options are often last resorts. 


Medline Plus Medical Encyclopedia. Endometriosis. Accessed 7/30/09.

Nasir, Laeth and Bope, Edward T. Management of Pelvic Pain from Dysmenorrhea or Endometriosis. The Journal of the American Board of Family Practice 17:S43-S47 (2004)

National Institute of Child Health and Human Development. What is Endometriosis? Accessed 7/30/09.

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