by Hector Chapa

Created on: April 28, 2008   Last Updated: April 29, 2008

Endometriosis is a common Gynecological, benign condition that may affect up to 10% of the general female population. In those seeking medical care for infertility (difficulty conceiving ) it may be as high as 35%. Endometriosis is not a cancerous or life threatening condition, and it's symptoms vary in different women. Some women are unaware that they possess it while others suffer with it daily.

Endometriosis usually presents in a woman's teenage (or reproductive ) years. While the cause is not completely understood, it is highly suspected that the flow of menstrual blood during a woman's cycle out through the fallopian tubes is the culprit. This menstrual fluid ends up in the pelvis of the woman, implants there, and over time leads to the symptoms of endometriosis.

The most common symptoms include menstrual pain in the pelvis, daily pain in the pelvis, painful intercourse (sex) and pelvic bloating or fullness. As previously mentioned, it can also present in women who are having difficulty with conception (infertility). If endometriosis involves the deep nerves on the pelvis, it may present as hip or lower back pain especially during one's menstruation.While not associated with ovarian cancer, endometriosis may be present on the ovary and present as an ovarian mass or tumor requiring surgery. The symptoms of endometriosis usually resolve during menopause as the hormonal background of the patient begins to change (less estrogen).

The diagnosis can be made on the basis of the patients' symptoms as detailed above. Endometriosis cannot usually be seen on a pelvic sonogram unless associated with an ovarian mass (endometrioma). Occasionally, a camera can be placed in the patients abdomen under general anesthesia to confirm the diagnosis. This process is called laparoscopy and can be performed as an outpatient procedure.

The treatment of endometriosis is divided into two categories : medical or surgical. In general, most of the time treatment consists of medications to "hormonally" treat the conditions. These medications include birth control pills, Depo-Provera, a special progesterone containing IUD, or an injection called Lupron. All of these therapies work by manipulating the patients hormones in an attempt to "starve" or "reduce" the endometriosis in the pelvis. If the patient has a suspected ovarian mass related to endometriosis or suffers from infertility, occasionally surgery is done in an attempt to "clean the pelvis" of the condition. This is usually done by excision of the endometriosis lesions or by laser vaporization.

The "cure" of the condition comes from the removal of the uterus and ovaries (hysterectomy with ovarian removal) and is reserved for cases where medications failed and/or the patient no longer desires future pregnancies.

Patients should recognize that endometriosis is a chronic condition. The treatment options should focus on the patients symptoms, desires and age. Patients and their doctors should work together to arrive at the best possible course of therapy.

Information from the American College of Obstetricians and Gynecologists

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