Each month, millions of women experience painful menstrual cycles that disrupt their lives – and don’t know why. A common cause may be endometriosis, or chronic inflammation in the pelvis, which can be treated. And it’s important to do so, because no one should live with chronic pain – and delaying treatment in endometriosis can lead to infertility.
Endometriosis occurs when the tissue that lines the uterus also grows outside the uterus, attaching to the ovaries, fallopian tubes or tissue lining the pelvis. During a typical menstrual cycle, the lining in the uterus, or the endometrium, builds up and is then shed as menstrual flow. In endometriosis, however, endometrium cells build up outside the uterus, causing bleeding, swelling, scarring, and pain within the pelvis and abdomen.
The condition is seen in approximately 10 percent of women in their reproductive years. While the actual cause is still uncertain, among the causes that researchers suspect are retrograde menstruation (when a menstrual flow goes backward, through the fallopian tubes, into the pelvis), a complication of the immune system, a hormonal imbalance, or scarring from previous abdominal surgeries. A family history of endometriosis increases the risk.
Don’t ignore the symptoms
Pelvic pain during menstruation is the most common symptom, yet other red flags include:
• Painful intercourse
• Pain during urination or bowel movements
• Ovarian cysts
• Excessive bleeding during menstruation
• Difficulty conceiving within one year
If you experience any of these symptoms, talk to your gynecologist. You’ll want relief from pain but also to rule out the possibility of endometrial cancer, which can have similar signals. And if you have pelvic pain and are having difficulty conceiving, you may need to see a reproductive endocrinologist with an expertise in endometriosis.
Treatments from surgery to diet
The pain of endometriosis can be treated with over-the-counter pain ibuprofen or acetaminophen and birth control methods that suppress the hormones that make the endometriosis grow. Hormone therapy and laparoscopic surgery to remove the errant cells may also bring relief.
Recent research also indicates that changing your diet can help fight endometriosis. Studies have shown that women who eat a diet rich in vegetables and fruits are at less risk of developing advanced endometriosis.
That’s because edible plants are high in compounds called isoflavones that reduce inflammation. Food high in vitamin D – fatty fish, cheese, eggs, liver, milk, yogurt and orange juice – have also been shown to help. Even green tea, also with anti-inflammatory compounds, has been shown in laboratory studies to reduce the lesions caused by endometriosis.
Endometriosis and fertility
The inflammation endometriosis causes may prevent a fertilized egg from attaching to the lining of the uterus to begin a pregnancy. The condition, therefore, is a common threat to fertility: 25 to 50 percent of women experiencing infertility have the condition. And 30 to 50 percent of those women will need medical intervention to conceive.
Treatments include laparoscopic surgery and intrauterine insemination. Your fertility specialist will talk with you and your partner about your medical histories and perform any necessary testing.
Pinpointing the cause of infertility can take some time but don’t be discouraged. Once the cause is found, whether endometriosis or another issue, they will develop a treatment plan to help you try to conceive.
Debilitating monthly pain need not be “just part of being a woman.” If endometriosis is the cause, know that it can be treated and it doesn’t need to interfere with your plans, including pregnancy.