What is Endometriosis

Written by: Dr. James Gorman

Endometriosis is a very common condition that is typically associated with severe pelvic pain and cramping that begins just before the menstrual period, continues through the menstrual period and improves as the menstrual period resolves.

Endometriosis is caused by the presence of cells that are typically within the uterine lining being present outside of the uterus. These cells are most commonly found on the ovaries, on the pelvic side wall, and deep in the pelvic cul de sac.

In addition to pelvic pain, endometriosis can also be a cause of infertility.

Endometriosis is a dilemma because treatment can only begin after a diagnosis is made. A definitive diagnosis is made by performing a laparoscopy and looking within the patient’s pelvis. The benefit of a laparoscopy is that it not only allows the diagnosis, but at the same time the endometriosis can be treated using electrical energy or laser. One of the problems with endometriosis though is that only visible lesions are able to be treated surgically. Endometriotic lesions begin as microscopic changes, so it is not possible to surgically treat all the endometriosis that may be present.

A second method of addressing endometriosis is medical treatment which essentially blocks the hormonal stimulation of the endometriosis, and therefore diminishes or eradicates the pain.

Not all patients with symptoms of endometriosis require surgery. Frequently the first step in addressing a presumptive diagnosis of endometriosis is to use the birth control pill. The birth control pill limits the hormonal stimulation of the endometriotic cells and reduces the response of these cells.

Overall most patients with endometriosis have a very good prognosis and go on to tolerable menstrual cycles, and eventually child bearing.