Endometriosis: Everything You Need to Know

If you don’t have endometriosis, you’ve probably heard of it – it affects about one in ten women of reproductive age. Although the condition’s two main symptoms are pelvic pain and infertility, both are treatable, and women with endometriosis often go on to have healthy pregnancies.

If you are having pelvic pain or trouble getting pregnant then you should schedule an appointment with your practitioner and we can refer you, if necessary, to a specialist.

What is endometriosis?

Endometriosis is a condition where cells from the endometrial lining implant and grow outside of the uterus (including on the ovaries, the pelvic cavity and the fallopian tubes), causing inflammation and scar tissue that can lead to pelvic pain and infertility.

What are the causes of endometriosis?

There are several potential causes, including:

  • Retrograde menstruation: During menstruation, while most of the blood and tissue flows out of the vagina, a small amount of blood and tissue travels up backwards through the uterus and fallopian tubes and into the pelvic cavity. In most women, the immune system gets rid of that blood and tissue. By contrast, the immune system of women with endometriosis is unable to fully eliminate the backflow. Therefore, tissue from the uterine cavity is able to stick to and invade areas outside of the uterus. This is the most common cause of endometriosis.
  • Blood or lymphatic system spread: endometrial cells can spread to other parts of the body (the pelvic cavity in particular) through blood.
  • Coelomic Metaplasia: in this case, cells in other parts of the body unrelated to the uterus turn into endometrial cells.

What are the symptoms?

Pelvic masses, pelvic pain and infertility are the main symptoms of endometriosis. All of them can be treated, but not necessarily at the same time. In some cases, women with endometriosis have no symptoms at all and are diagnosed only after they seek a reproductive endocrinologist’s help in getting pregnant.

How is the condition diagnosed?

While checking for symptoms and performing a physical exam is an important first step, the only real way to diagnose endometriosis is through a biopsy obtained during surgery. There is no blood test for endometriosis.

How is endometriosis treated?

When treating endometriosis, it is important to first identify whether a patient is mainly concerned with addressing her pain or treating infertility. It is not always possible to simultaneously relieve a patient’s pain and also help her to become pregnant. If a woman is not looking to conceive and just wants to alleviate her pain, over the counter pain killers like Advil or Motrin, as well as hormonal treatments like birth control pills or the Mirena IUD, can help.

Patients whose main concern is pregnancy will likely require treatment with fertility medications and either artificial insemination or in vitro fertilization (IVF). IVF is the most effective treatment for infertility in patients with endometriosis because it bypasses pelvic scar tissue and enables the sperm and egg to meet in a controlled environment. However, even in IVF, women with endometriosis have slightly lower pregnancy rates than other individuals with infertility.

So I can get pregnant if I have endometriosis?

Yes, you read that right! You might need a little help through IVF, but you can get pregnant.

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