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Information from Your Family Doctor
Am Fam Physician. 1999 Oct 15;60(6):1767-1768.
See related article on endometriosis.
What is endometriosis?
The word “endometriosis” (say it this way: end-oh-me-tree-oh-sis) means a problem with the lining of the uterus. The lining is called the endometrium. Normally, every month when you have your period, the lining (which is also called endometrial tissue) comes out in your menstrual flow.
Endometrial tissue is usually only inside your uterus. However, if you have endometriosis, tissue from the lining of the uterus moves through the fallopian tubes and gets on your ovaries, in your pelvis, on your bladder or in other areas. When you have your period, this tissue swells and bleeds, just like the lining of your uterus. This is often painful, and scar tissue can form in your pelvic area.
Is endometriosis harmful to me?
Endometriosis may hurt, but it doesn't cause cancer or affect your overall health, although it might make it harder to get pregnant.
How does my doctor know I have it?
There's no easy way to tell you have this problem. If you have severe cramping and pain during sex or at the beginning of your period, or low back pain or rectal pain, you may have endometriosis. If you have these kinds of pain, your doctor still may not be sure if endometriosis is the cause. Many other health problems cause pain like this. The only way for your doctor to be sure is to look inside you. Your doctor may want to do a laparoscopy (say it this way: lap-ah-ross-ca-pee). This is a way of looking inside you by making a small cut in your skin and putting a thin tube inside. You would be given medicine so you wouldn't feel any pain.
Can anything treat endometriosis?
A number of medicines might help with your pain. Sometimes it helps to take birth control pills. Another medicine that might help is a long-acting progestin (this is a hormone that comes in a shot; it's also used for birth control). Other medicines are danazol (brand name: Danocrine) or a monthly shot of a hormone called a GnRH analog.
What do these medicines do?
These medicines stop your periods. They may cause side effects like the ones women have at menopause. These include hot flushes and vaginal dryness. Danazol might cause acne and make your voice deeper. Sometimes the side effects of the GnRH analog go away if you also take an estrogen pill every day.
How long does treatment last?
Birth control pills, danazol and GnRH analogs are taken for six to nine months. During that time, your pain should get better. After you stop taking the medicine, the pain may come back.
What about pregnancy?
It's important not to get pregnant while you're taking these medicines. And if you want to get pregnant after the treatment is over, these medicines don't improve your chances of getting pregnant. If you don't want to get pregnant after the treatment, you should keep using birth control.
What about surgery?
Surgery is also used to treat endometriosis. In this surgery, the doctor removes the endometrial tissue from the wrong places. If endometriosis is keeping you from getting pregnant, surgery might make it easier for you to have a baby. You might still need other kinds of fertility treatments, if you want to get pregnant.
Will I ever be cured of endometriosis?
Endometriosis will probably go away at menopause, when you no longer have periods. Until then, you might have less pain if you get medical or surgical treatment.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 1999 by the American Academy of Family Physicians.
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