Endometriosis: Tricky to Diagnose, Manageable with Treatment

Some women suffer with pelvic pain and infertility caused by endometriosis. But, for many of these women, it can take quite some time to nail down this diagnosis and start managing the disease.

Endometriosis is a disease that causes lining – similar to lining within the uterus – to grow in other places in the body. According to the U.S. Department of Health and Human Services, most often the tissue “implants” grow:

  • Behind your uterus
  • On or under your ovaries
  • On the tissue holding your uterus in place
  • On your bowels or bladder
  • On your fallopian tubes

There isn’t a known cause of endometriosis. If you’re within reproductive age, you’re at risk of developing the disease, though you’re at higher risk if your immediate female relatives have been diagnosed with it.

Endometriosis can be difficult to diagnose because other than women feeling pain during the time of month when their hormones surge for their menstrual cycle, there might not be symptoms. Typically, the tissue – wherever it grows – becomes painful with these hormone flair ups, and women begin searching for a reason for the pain, which eventually leads to a diagnosis.

Endometriosis has a reputation of sometimes being a disease that health care providers overlook, says Larry Holland, DO, of Premier Women’s Center, part of Premier Physician Network. Women have sometimes had to switch doctors and get multiple opinions before finding someone who is able to pinpoint the reason for their pain.

Because a variety of other issues can cause similar pelvic pain, endometriosis can sometimes be mistaken for other health issues.

In addition to the pain caused by endometriosis, it can also lead to infertility in many women who suffer from it, Dr. Holland says.

“Endometriosis has four different stages. It goes from minimal to mild to moderate to severe. Usually stage one or stage two, it probably doesn’t affect fertility, but when you get to stage three and stage four it definitely can affect fertility,” he says. “I don’t want to say it makes women infertile, but it makes them what I call subfertile – a little bit harder to get pregnant.”

Treating Endometriosis

When treating endometriosis, health care providers usually start with over-the-counter pain medication, such as ibuprofen, then move on to low-level birth control as a second option if the pain medication doesn’t help, Dr. Holland says.

If needed, providers might go to a stronger medication, such as Depo-Provera, to try to shut off your ovaries because the lack of hormone production helps control the pain, he says.

The final step in treatment options would be surgery. If surgery is a necessity, there are minimally invasive options such as laparoscopic or robotic surgeries that may mean less pain and recovery time for the patient.

“The goal there is to remove and destroy the endometrial implants that are in there. And removal of the lesions is probably the best, but that’s reserved for the incapacitating symptoms,” Dr. Holland says.

Among the variety of treatment options, women are often able to find ways to manage the symptoms of endometriosis, but Dr. Holland says he hesitates to say it’s a disease that can ever be fully cured.

“As long as your ovaries are still functioning, endometriosis can return,” he says. “So what we try to do, we try to manage the symptoms to make life as productive as possible.”

To learn more about endometriosis, talk to your doctor or health care provider or search for a provider.