Approximately 11 percent of pre-menopausal women are affected by endometriosis, a common and often painful disease in which endometrial growths develop outside of the uterus. These lesions are typically found in the lower abdomen and pelvic region, but it’s possible for endometriosis to appear anywhere in the body. Although growths from endometriosis are non-cancerous in the majority of cases, Dr. Rachael Haverland — our board-certified gynecologist — understands how disruptive and painful this condition can be for many women.
Stemming from her fellowship training under Dr. Javier F. Magrina and Dr. Megan Wasson at the renowned Mayo Clinic, Dr. Haverland developed a strong passion for helping women enjoy life free from the pain of endometriosis. With her extensive experience treating pelvic pain, as well as her fellowship training in minimally invasive gynecologic surgery, Dr. Haverland can create an endometriosis treatment plan for you that is custom-tailored to improve your symptoms.
What are Common Symptoms of Endometriosis?
Pain is usually the most prominent symptom of endometriosis and may vary in its severity, duration, and location. The reason for endometriosis’ characteristically painful symptoms is that endometrial lesions outside the womb can swell or bleed just like the uterine lining during your monthly menstrual cycle — except with these outer tissue growths, there is nowhere for blood to easily exit the body. This can cause irritation, inflammation, and pain during and after your period, in addition to other menstrual and reproductive health issues. Typical symptoms of endometriosis often include:
- Intensely painful menstrual cramps
- Painful intercourse
- Lower back or pelvic pain
- Pain from urinating or bowel movements
- Bleeding or spotting between periods
- Stomach and bowel problems, such as diarrhea, nausea, constipation, or bloating
- Issues with fertility or an inability to get pregnant
If you’re struggling with any of the above symptoms, it’s important to speak with a doctor about your concerns to determine whether endometriosis may be the cause. Dr. Haverland also encourages patients to find supportive networks and advocate for themselves by joining educational groups, such as Nancy’s Nook Endometriosis Education. This Facebook group can provide comprehensive resources for women coping with endometriosis, as well as their loved ones.
What Causes Endometriosis?
Exact causes of endometriosis are unknown, but there are several prevailing theories. Retrograde menstrual flow, wherein blood flows through the fallopian tubes rather than out of the vagina, may be a contributing factor. However, this occurs to some extent in most women who are of reproductive age and may not be indicative of endometriosis by itself. Other explanations include the transport of uterine cells through the blood vessels and lymphatic system, which may be a reason why endometrial lesions are sometimes found in unusual parts of the body. Rarely, endometriosis may also be found in pre-pubescent and post-menopausal women, lending further support to the theory that endometriosis is spread through the blood or lymphatic systems. Endometriosis can also accidentally spread during abdominal surgery, such as a C-section. The risk of developing endometriosis is usually higher if it also affects a close family member, which suggests a possible genetic influence on one’s likelihood of being diagnosed with the disease.
How is Endometriosis Treated?
At Highland Gynecology, Dr. Haverland offers several non-invasive, laparoscopic, and surgical treatments for endometriosis that can manage or even completely eliminate symptoms. She can work with you to determine the presence of endometrial lesions and develop the best care plan for your needs.
If your symptoms are mild, pain medication may be enough to assuage endometriosis symptoms. Depending on the type of pain you experience, non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or prescribed pain medication can be taken to alleviate discomfort. This is considered the most conservative endometriosis treatment, and therefore the effectiveness of this method is limited.
More often, hormone therapy is able to successfully treat endometriosis pain without surgery. This can be administered in the form of hormonal birth control, progestin-only pills, or Gonadotropin-releasing (GnRH) medicines. While they are not intended for women who are trying to get pregnant, oral contraceptives or an IUD can be utilized to lighten, shorten, or stop your menstrual cycle as well as alleviate painful symptoms. In some cases, GnRH medicines — which can stop the body from producing certain hormones — may be recommended to prevent the growth of endometriosis. This temporarily induces a “menopause-like” state to bring relief from endometriosis pain. Some side effects of the medication can be significant, and it’s important to discuss these possibilities with Dr. Haverland.
It’s important to note that while hormone therapy can help endometriosis symptoms, medication alone will not make endometriosis go away long-term; however, hormone therapy can be a good option to manage symptoms for the short-term and avoid surgery.
Full Endometriosis Resection
If hormone therapy and other conservative treatments haven’t worked for you, endometrial resection may be the best course of action. During this procedure, endometriosis lesions (as well as scar tissue) are removed from outside the uterus. Full surgical resection of endometriosis has been shown to improve infertility and long-term symptoms. Dr. Haverland is able to perform this resection surgery using the highly advanced da Vinci® system, which can result in shorter incisions, less post-operative discomfort, and a faster recovery period than comparable techniques.
A hysterectomy, a surgical procedure to remove the uterus, can also bring relief from endometriosis symptoms. This treatment option is generally reserved for those who experience severe pain and who have not had any success with other techniques. Like endometriosis resection, Dr. Haverland can also perform a hysterectomy via the da Vinci® robotic-assisted system, laparoscopically with the da Vinci® robot, or vaginally. The best approach for you can be determined in a consultation.
Dr. Haverland will always consider the most conservative endometriosis treatments before suggesting more invasive treatment plans. If you would like to discuss your symptoms in person, Dr. Haverland would be happy to meet with you in a private consultation. For more information, or to book an appointment, please contact Highland Gynecology at our Highland Park practice for more information.