Dr. Carolyn's Corner
ENDOMETRIOSIS AWARENESS MONTH
Among the many causes and diseases that have named March as their “awareness month”, one that is particularly applicable to women is endometriosis. Several years ago the U.S. Government designated March as National Endometriosis Awareness Month in an effort to formally recognize this common disorder and to raise public awareness about it. The movement's goal is to improve both patient and physician understanding of what is often a debilitating condition, as well as the development of more effective treatments and ultimately a cure.
Endometriosis, most commonly diagnosed during a woman's reproductive years, occurs when endometrial tissue (the lining of the uterus) begins to grow outside the uterus. It is most often found on the ovaries, fallopian tubes, outer layer of the uterus and pelvic peritoneum, as well as the intestines and bladder. Like normal endometrium, this tissue responds to the effects of hormones and bleeds, similar to a period. The body may respond to this internal accumulation of blood with an inflammatory reaction and by forming scar tissue (adhesions), both of which can explain the pain that patients experience.
Although pain, both menstrual and chronic, is the most frequent symptom described by patients, it is interesting that the degree of pain does not correlate well with the amount of endometriosis or scarring present. In other words, some women with extensive disease have little or no pain, while those with very little endometriosis and scarring may have severe pain that affects their daily lives. Often the diagnosis is made in the course of a work-up for infertility. It is estimated that 30-40% of female infertility cases are related to this disorder.
Unfortunately, even after decades of research, the cause of endometriosis is still not fully understood. There are many theories, but none alone explains all cases. Therefore, the answer may lie in a combination of the proposed ideas, and only through continued research will this puzzle be solved. Following that, hopefully a cure will be found.
For the present ,we manage the disorder through medical, hormonal, and surgical treatments. Three main goals are: 1) pain relief, 2) keep the disease from progressing, and 3) preserve or restore fertility as needed. A treatment plan is chosen based on the patient's desire for childbearing. It is important that patients understand that not all treatments work for all cases and that recurrences of symptoms are not uncommon.
If you have been diagnosed with endometriosis, or suspect you have it, I strongly encourage you to find a physician who is experienced in its management and who you are comfortable communicating with. Also there are many national and local endometriosis support groups that have been established to help patients and their families work together to deal with the issues associated with this complex disorder and share personal experiences. Not only can you personally benefit from being a part of a group, it's a wonderful opportunity to help others.