For many women, period pain is an expected part of life. But for those with endometriosis, the pain can be unbearable — going beyond cramps and disrupting daily activities. With approximately one in 10 women of reproductive age affected, it’s crucial to recognise the symptoms, seek early diagnosis and explore treatment options that can provide relief.

Usually diagnosed during childbearing years, endometriosis is caused when cells of the inside lining of the uterus, the endometrium, are found outside of the uterus. These cells can implant on the peritoneum, ovaries, fallopian tubes, bladder, ureters, intestines and rectum.

The lesions of endometriosis react to rise and fall of estrogen during the menstrual cycle and can make the surrounding tissue become irritated, inflamed and swollen. The breakdown, or sloughing, of the tissue each month can cause scarring. Scarring leads to adhesions, which can cause organs to stick together, leading to long-term problems.

Endometriosis can contribute to infertility as well; disrupting egg reserves of the ovary and sometimes interfering with the movement of the egg and sperm through the fallopian tubes. In the most severe cases, adhesions or scar tissue may block fallopian tubes.

The symptoms of endometriosis vary from woman to woman. The most common symptoms of endometriosis include pelvic pain related to your menstrual period. Sometimes women with endometriosis will have no symptoms and they are diagnosed when they are unable to get pregnant or are having surgery for something else.

Endometriosis can be diagnosed by your OB-GYN with a thorough review of your symptoms and physical exam, which may include a pelvic exam. Imaging testing such as a pelvic ultrasound or MRI, may also be used to help aid in the diagnosis of endometriosis. The only way to know for sure that you have endometriosis is through a surgical procedure called a laparoscopy, which is when a camera is placed into your abdomen to look for lesions of endometriosis. Removal or biopsy of any suspicious lesions may be performed during this procedure.

Treatment for endometriosis depends on the extent of your condition and symptoms. It can be treated with medication, surgery, physical therapy or a combination of all three. If pain is the biggest symptom, medication will be tried first.

The most common medications for treatment are pain relievers and hormonal medications. Hormonal medications help slow the growth and stimulation of the endometrial tissue lesions and may keep further adhesions from forming. Medication does not eliminate tissue that is already present.

If the surgical option is taken, the goal of the procedure is to identify and remove endometriosis tissue. Removing the tissue can improve pain and increase fertility. The last resort option for endometriosis is a hysterectomy. If the ovaries are removed during surgery, it can be more effective.

If you suffer from any of these symptoms, talk to your gynecologist about investigative options and treatments.

UK HealthCare is the hospitals and clinics of the University of Kentucky. But it is so much more. It is more than 10,000 dedicated health care professionals committed to providing advanced subspecialty care for the most critically injured and ill patients from the Commonwealth and beyond. It also is the home of the state’s only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, a Level IV Neonatal Intensive Care Unit that cares for the tiniest and sickest newborns, the region’s only Level 1 trauma center and Kentucky’s top hospital ranked by U.S. News & World Report.

As an academic research institution, we are continuously pursuing the next generation of cures, treatments, protocols and policies. Our discoveries have the potential to change what’s medically possible within our lifetimes. Our educators and thought leaders are transforming the health care landscape as our six health professions colleges teach the next generation of doctors, nurses, pharmacists and other health care professionals, spreading the highest standards of care. UK HealthCare is the power of advanced medicine committed to creating a healthier Kentucky, now and for generations to come. 

The University of Kentucky Public Relations and Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by George K. Thomas, assistant professor of obstetrics and gynecology in the University of Kentucky College of Medicine.