Chronic pelvic pain -- typically during menstruation -- is the most common indication of endometriosis, an incurable inflammatory condition that can cause infertility, an expert says. In fact, it is among one of the leading causes of infertility in Black women.
About 10% of women have the disorder in which tissue that normally lines the uterus grows outside of it and can spread to areas such as the fallopian tubes, ovaries and pelvis. A study by the American Journal of Obstetrics and Gynecology reported that 40% of African American women who were told they had pelvic inflammatory disease actually had endometriosis.
Day 1: Just Diagnosed with Endometriosis
More than painful periods
"The most common symptom of endometriosis is painful periods," says Dr. Kristin Riley, interim chief of the Division of Minimally Invasive Gynecologic Surgery at Penn State Health Milton S. Hershey Medical Center in Hershey, Pa.
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"We're talking about the kind of pain that doesn't go away with a simple treatment, like over-the-counter medications," she said in a center news release. "Pain that keeps you from going to work or school or from participating in social activities."
Typically, the pain occurs before, during or just after periods. But Riley says some women may only have pain during ovulation or intercourse, while others experience pain only during bowel movements.
"Some people get painful flares and then get relief for a long period of time," Riley adds.
Complications
Infertility
Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant because endometriosis may obstruct the tube and keep the egg and sperm from uniting. Additionally, the condition may damage the sperm or the egg.
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Despite this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. In order to achieve this, your doctor may advise you not to delay having children because your condition may worsen with time.
Cancer
Ovarian cancer occurs at higher than expected rates in women with endometriosis, however, the overall lifetime risk of ovarian cancer is low, to begin with.
Endometriosis-associated adenocarcinoma can also develop later in life in women who have endometriosis, however, it is rare.
Getting diagnosed
It takes an average of seven to 10 years for a woman to get a confirmed diagnosis, mainly because there is no noninvasive test for endometriosis.
"We can try an MRI or ultrasound, but most of the time patients with endometriosis have normal pelvic imaging," Riley shares. Research is underway to develop diagnostic blood tests, but for now, a definitive diagnosis can only come from laparoscopy. That's a minimally invasive surgery in which doctors use a long, skinny camera to examine the pelvis.
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However, treatment can begin before doctors confirm the disease.
Among the treatments are anti-inflammatories; suppressing menstruation with a birth control or progesterone pill or intrauterine device; other hormonal treatments; nerve pain drugs or endometriosis-specific medications, and laparoscopic surgery to remove abnormal tissue.
Most patients Riley sees for endometriosis are in their 30s and 40s, but some are in their teens and their 50s.
"In most patients, the pain gets better after menopause, but a small percentage will continue to have pain," she notes.
When to see a doctor
If you have signs and symptoms that may indicate endometriosis, consult with your doctor.
Endometriosis can be a challenging condition to manage. However, an early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis will help you better manage your symptoms.
