Killer Cramps or Something More?

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If you’re a woman past the age of puberty, odds are that you’ve experienced some menstrual cramping during your period. Most of us accept it as a fact of life, but for some women, it may signal endometriosis.

If you have endometriosis, the tissue that typically lines your uterus begins growing in other areas of your pelvis or beyond, often causing a range of symptoms from mild to severe.

What Are Symptoms of Endometriosis?

Women with endometriosis don’t always have symptoms, but inflammation and bleeding of the abnormally growing endometrial tissue can lead to pain and discomfort. Some common signs to watch for include:

  • Severe menstrual cramps or heavy menstrual cycles
  • Long-term pain in your lower back and pelvis
  • Pain before or during your menstrual period
  • Pain during or after sex, usually described as “deep” pain that’s not at the entrance of the vagina
  • Intestinal discomfort
  • Painful bowel movements or urination during your menstrual cycle
  • Bleeding or spotting between periods
  • Fatigue
  • Stomach and digestive problems, including diarrhea, constipation, bloating or nausea, especially during menstrual periods
  • Trouble getting pregnant. Endometriosis greatly reduces fertility and occurs in up to 50 percent of infertile women. However, not all women who have endometriosis are infertile.

After menopause, some women feel less pain, but this is not always true. If you take hormones or medicines to reduce menopausal symptoms, you may continue to have symptoms of endometriosis.

Heather Hilkowitz, MD, Hilltop Obstetrics & Gynecology, describes the symptoms of endometriosis.

Click play to watch the video or read the transcript.

What are the symptoms of endometriosis?

As far as symptoms of endometriosis go these kinds of symptoms vary widely from one patient to another. One woman might not really have much in the way of pain at all whereas another patient they have lots of pain not only with their periods but sometimes even starting several days to a week ahead of time with the pain only intensifying as the cycle gets closer and closer. Some women don't have as much prominent symptoms with their cycles per se but may have pelvic pain and other times of the month as well as pain during and after intercourse which can become rather problematic and disruptive. On the more severe end of the spectrum women with endometriosis can have some problems getting pregnant or sustaining a pregnancy and in some cases they can develop cysts on the ovary that are filled with endometriosis like tissue in cells that accumulate over time thus enlarging the ovary becoming problematic as far as pain and further infertility problems. Usually these cysts are filled with dark chocolate like fluid called chocolates cysts. We can often feel them on ultra, on pelvic exams or can see them when ultrasound that would give us an idea that they’re there and need to be treated.

 

How Do You Diagnose Endometriosis?

Your physician or healthcare provider will listen to your history of symptoms and perform a pelvic exam as the first step in checking you for endometriosis. These may give her with a good idea about whether you have the condition, but they won’t provide proof of the diagnosis.

If you are having symptoms, a laparoscopy offers the best way to diagnose endometriosis. In this outpatient procedure, a tiny camera is inserted into your abdomen through a small incision. The camera takes pictures of the surface of your uterus, fallopian tubes, ovaries and other pelvic organs. If necessary, your doctor can remove a small sample of tissue, called a biopsy, for further study.

Women with endometriosis don’t always have symptoms.

Ultrasound or other imaging tests cannot confirm the condition. But they can be useful in identifying cysts or other causes of pelvic pain or infertility.

Dr. Hilkowitz talks about diagnosing endometriosis.

Click play to watch the video or read the transcript.

How is endometriosis diagnosed?

Endometriosis can be diagnosed and a variety of different ways all the surgery is really the most definitive an absolute way to secure the diagnosis. Your doctor might be able to diagnose you with it just by listening to your signs and symptoms like pain with your periods and other times of the month pain, with sex or maybe even some infertility problems. Other times we rely on surgical diagnoses where we actually are inside the abdomen looking either with the camera or with her eyes to be able to tell the endometriosis is there. Unfortunately you can't really diagnose. Is there unfortunately you can't really diagnose endometriosis by looking at an ultrasound for a CAT scan or an MRI or other types of imaging so we have to really listen to our patients and understand if they have symptoms that are suspicious and if needed surgery certainly can make the diagnosis 100 percent.

 

How Serious Is Your Endometriosis?

Doctors classify endometriosis as minimal, mild, moderate or severe. Most women have minimal or mild endometriosis. The stage depends on factors such as:Killer Cramps or Something More - In Content

  • Number, size, and site of endometrial tissue implants
  • Presence and extent of adhesions (scar tissue)
  • Involvement of other pelvic organs

The stage may not match the pain you feel. Even early stages can cause a lot of pain.

Having a diagnosis will allow you to take action in resolving your symptoms.

Learn more about medical therapies and surgical options for endometriosis.

Heather L. Hilkowitz, MD

Heather L. Hilkowitz, MD

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Small Steps: Lower your risk.
Exercise to lower body fat, and reduce alcohol and caffeine intake to lower the amount of estrogen in your blood.