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Pelvic Pain & Endometriosis: Treatments for a Problem Many Women Experience

Mar 02, 2011

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Karyn Odway, karyn@cyanpoint.com
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Endometriosis is the most common cause of severe, chronic pelvic pain and infertility. The condition, which occurs when cells from the tissue that normally lines the inside of the uterus begin to grow on other organs, affects up to a third of all child-bearing age women and at different life stages. Fifty percent of teenage girls with chronic pain will be diagnosed with endometriosis, and it’s the cause in half of all women who have been deemed infertile.

“Many women needlessly suffer with this pain,” said Carlos Rotman, M.D., chief of gynecology and medical director of Women’s Health at Weiss Memorial Hospital and associate professor of obstetrics and gynecology at Rush Medical College. “There are a number of treatments that can alleviate the pain and increase a woman’s chance to get pregnant. Being diagnosed with endometriosis doesn’t mean a painful, childless life.”

It’s not clear why some women develop endometriosis, but there is a genetic component. Proper diagnosis is imperative to getting the treatment women need, Dr. Rotman said. In many cases, a primary care provider may suspect someone is suffering from endometriosis and will help a patient manage her condition. But in more complex cases (especially those resulting in infertility or those who have not responded adequately to the first line of treatment),  a referral to a gynecologist who specializes in endometriosis may be needed.

The best methods for detecting endometriosis are ultrasound, which uses sound waves to produce an image of the pelvic and abdominal organs, and laparoscopy, a surgical procedure where a lighted telescope, attached to a camera, is inserted into the abdomen to directly visualize the pelvic organs. Endometriosis can have a distinct appearance, with lesions that look like cigarette burns on the surface of the pelvic organs and abdominal wall. Keep in mind, the severity of the pain does not necessarily indicate the extent of endometriosis.

Once a diagnosis is made, Dr. Rotman says women have several treatment methods to ease the pain:

  • Oral medications. Endometrial tissue relies on estrogen to grow, so oral treatments such as birth control pills are helpful in preventing cells from thickening and causing pain, but endometriosis often recurs when the woman stops taking the medication. Anti-inflammatory medications also can ease the pain symptoms.
  • Hormone-free diet. Going organic, especially with dairy products, might help this estrogen-feeding disease. Avoid any soy or phytoestrogens products too.
  • Surgery. Sometimes surgery is necessary to remove or destroy the endometrial tissue if a woman wants to preserve her fertility. After menopause, when a woman's hormones have declined substantially, this disease is less of an issue, but for some women beyond their child-bearing years, a hysterectomy with bilateral salpingo-oophorectomy (the removal of the uterus, both ovaries and the fallopian tubes) may be the only solution to eliminating the pain associated with endometriosis.