Living with endometriosis
You have a condition called endometriosis. Symptoms of endometriosis include:
- Heavy menstrual bleeding
- Bleeding between periods
- Problems getting pregnant
Having this condition can interfere with your social and work life.
No one knows what causes endometriosis. There is also no cure. However, there are different ways to treat the symptoms. These treatments can also help relieve menstrual pain.
Learning how to manage your symptoms can make it easier to live with endometriosis.
Endometriosis - Animation
A common gynecological problem in women occurs when cells that are supposed to form in the uterus of a woman, attach themselves to tissue in other places of the body, causing pain, irregular bleeding, and problems with getting pregnant, or infertility. Let's talk about endometriosis in a little more detail. Every month, a woman's ovaries produce hormones that tell the cells lining the uterus, or womb, to swell and thicken. The body removes these extra cells from the womb lining, or endometrium, when you get your period. But if these cells, called endometrial cells, implant and grow outside the uterus, endometriosis results. The growths are called endometrial tissue implants. Women with endometriosis typically have tissue implants on the ovaries, or bowel, rectum, bladder, or on the lining of the pelvic area. We don't know what causes endometriosis. One theory is that the endometrial cells that shed when you get your period travel backwards through the fallopian tubes into the pelvis, where they implant and grow. This is called retrograde menstruation. This backward menstrual flow occurs in many women, but many think the immune system may also be different in women with endometriosis. Symptoms of endometriosis include painful periods, pain in your lower belly before and during menstruation, cramps before and during menstruation, pain during sex, painful bowel movements, as well as pelvic or lower back pain. To treat endometriosis...The goal of treatment is to improve pelvic pain, reduce pelvic masses, or improve fertility. If you have mild symptoms and do not want to have children, you may choose to have regular exams every 6 to 12 months so your doctor can make sure the disease isn't getting worse. Treatment options also include pain medicines, hormone medicines to stop the disease from getting worse, or surgery to remove the area of endometriosis or even the entire uterus and ovaries if you have severe pain that does not get better with other treatments. Hormone therapy doesn't cure endometriosis, but it can relieve some or all of your symptoms. Unfortunately, removal of the uterus, fallopian tubes, and both ovaries may eliminate symptoms, but it also eliminates fertility. A combination of limited surgery and assisted reproduction techniques may improve fertility. So, if you have any questions about endometriosis, please see your doctor.
Medicines to Treat Endometriosis
Your health care provider may prescribe different types of hormone therapy. These may be birth control pills or injections. Be sure to follow your provider's directions for taking these medicines. Do not stop taking them without talking with your provider. Be sure to tell your provider about any side effects.
Over-the-counter pain relievers can reduce the pain of endometriosis. These include:
- Ibuprofen (Advil)
- Naproxen (Aleve)
- Acetaminophen (Tylenol)
If the pain is worse during your periods, try starting these medicines 1 to 2 days before your period begins.
You may be receiving hormone therapy to prevent the endometriosis from becoming worse, such as:
- Birth control pills.
- Medicines that cause a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes.
Apply a hot water bottle or heating pad to your lower stomach. This can get blood flowing and relax your muscles. Warm baths also may help relieve pain.
Lie down and rest. Place a pillow under your knees when lying on your back. If you prefer to lie on your side, pull your knees up toward your chest. These positions help take the pressure off your back.
Get regular exercise. Exercise helps improve blood flow. It also triggers your body's natural painkillers, called endorphins.
Eat a balanced, healthy diet. Maintaining a healthy weight will help improve your overall health. Eating plenty of fiber can help keep you regular so you don't have to strain during bowel movements.
Techniques that also offer ways to relax and may help relieve pain include:
- Muscle relaxation
- Deep breathing
Some women find that acupuncture helps ease painful periods. Some studies show it also helps with long-term (chronic) pain.
If self-care for pain does not help, talk with your provider about other treatment options.
When to Call the Doctor
Call your provider right away if you have severe pelvic pain.
Call your provider for an appointment if:
- You have pain during or after sex
- Your periods become more painful
- You have blood in your urine or pain when you urinate
- You have blood in your stool, painful bowel movements, or a change in your bowel movements
- You are unable to become pregnant after trying for 1 year
John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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