The endometrium is a layer of cell tissue lining the uterus. During the menstrual cycle, the endometrium grows to be thick and blood vessel-rich, because this is the environment for the implantation of the baby if there’s pregnancy.
Endometriosis is usually a long-lasting (chronic) disease, you are born this way. When you have endometriosis, the type of tissue that lines your uterus (endometrium) is also present outside your uterus. These clumps/implants of tissue may have grown on your ovaries or fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases they spread to areas beyond the belly.
With each menstrual cycle, these clumps/ implants go through the same growing, breaking down, and bleeding that the uterine lining (endometrium) goes through. This is why endometriosis pain may start as mild discomfort a few days before the menstrual period and then usually is gone by the time the period ends. But if an implant grows in a sensitive area, it can cause constant pain or pain during certain activities, such as sex, exercise, or bowel movements.
So the main two problems with endometriosis are the chronic pain and the infertility.
There is no cure for endometriosis, but treatment can help with pain and infertility.
Treatment depends on how severe your symptoms are and whether you want to get pregnant. If you have pain only, hormone therapy to lower your body’s estrogen levels will shrink the implants and may reduce pain. If you want to become pregnant, having surgery and infertility treatment may help.
Not all women with endometriosis have pain. And endometriosis doesn’t always get worse over time. During pregnancy, it usually improves, as it does after menopause. If you have mild pain, have no plans for a future pregnancy, or are near menopause (around age 50), treatment may be unnecessary.
So how is endometriosis treated? If you have pain or bleeding but aren’t planning to get pregnant soon,birth control hormones (patch, pills, or ring) or anti-inflammatory medications (NSAIDs) may be all that you need to control pain. Birth control hormones are likely to keep endometriosis from getting worse. If you have severe symptoms or if birth control hormones and NSAIDs don’t work, you might try a stronger hormone therapy.
Besides medicine, you can try other things at home to help with the pain. For example, you can apply heat to your belly and exercise regularly.
If hormone therapy doesn’t work or if growths are affecting other organs, surgery is the next step. It removes endometrial growths and scar tissue. Laparoscopy can improve pain and your chance for pregnancy. In severe cases, removing the uterus and ovaries (hysterectomy and oophorectomy) is an option. This surgery causes early menopause. It is only used when you have no pregnancy plans and have had little relief from other treatments.
If you are having trouble becoming pregnant even after surgery, you can consider trying fertility drugs with insemination or in vitro fertilization. Endometriosis may have no permanent cure, but you can always discuss your family planning options with your doctor, and stick to a treatment plan, which might take long to succeed, so you will need to have patience.
Best of luck.