What are the symptoms of endometriosis?
The most common symptom of endometriosis is pain in the pelvis and low abdomen before and during menstruation.
Other common symptoms are pain with intercourse, heavy menstrual bleeding, bowel problems such as painful bowel movements during periods, diarrhea or constipation, and painful urination during periods.
Infertility is also a very common feature of endometriosis.
It's important to know that the amount of pain a woman experiences does not co-relate well with the number of endometrial growths she has, so that some women with only a few endometriomal growths can have lots of pain, while others with many growths will have only minimal pain.
How is endometriosis diagnosed?
Endometriosis is often suspected from a typical history of pain in a woman in her reproductive years.
Sometimes, endometriosis is picked up when the doctor feels a "mass" on the ovaries produced by an endometriosis cyst, but the diagnosis can only be confirmed with a laparoscopy, a "keyhole" look into the pelvis. This also allows the doctor to gauge the extent of the disease.
How is endometriosis treated?
A healthy lifestyle - diet, exercise, weight control, stress reduction - can help with the symptoms of endometriosis.
The pain of endometriosis is most often treated with analgesics, usually nonsteroidal anti-inflammatory drugs such as ibuprofen, although many women occasionally require more potent drugs, and some require them regularly.
Endometriosis can also be alleviated with drugs that stop ovulation such as oral contraceptives (which can be taken continuously to avoid periods altogether), progesterone (such as Depo-provera), and with more controversial drugs such as the GnRH agonists.
Danazol, a synthetic testosterone, is also sometimes used for severe cases of endometriosis. Danazol, however, produces many side effects (hot flashes, acne, weight gain, masculinization effects such as voice deepening and growth of the clitoris, mood swings, and others), and it has also been linked recently to an increased risk of ovarian cancer, so its use should be very limited.
Surgery has an important role to play in endometriosis. First, laparoscopy confirms the diagnosis and extent of the disease. Second, many women are helped immensely when endometrial tissue is excised, that is, when the surgeon finds the growths and destroys them. Equally important, appropriate surgery can improve the chances of pregnancy.