Mar 13, 2025
Endometriosis is a common condition, affecting 10-20% of women. At Advanced GYN Solutions in Wilmington, NC, we specialize in serving patients dealing with endometriosis. With symptoms that include pelvic pain, painful periods, pain with intercourse, and pain with urination or bowel function, we understand it can be a severe, life-altering condition.
What is Endometriosis
The condition occurs when the endometrial cells, which normally line the uterus, are outside the uterus, most commonly in the peritoneal cavity, where the tubes, ovaries, and intestines are located. Endometriosis can also occur in other areas of the body, although it is rare.
Each month during the menstrual cycle, these outside cells, just like the ones in the uterus, grow and proliferate, then slough off and bleed. When endometrial cells are outside of the uterus, it causes inflammation, pain, scarring, and infertility. These symptoms may affect one’s ability to work, go to school, enjoy intimacy, or become pregnant. Someone suffering from especially severe symptoms may even have trouble getting out of bed.
Endometriosis can be difficult to diagnose and, therefore, is often missed. Currently, there are no reproducible radiographic means to diagnose endometriosis. Ultrasound is used to exclude other causes of pain, such as cysts or fibroids. In the absence of pelvic pathology, women who have pelvic pain have a nearly 80% chance of having endometriosis. The risk is doubled if you have a family history of endometriosis.
Because endometriosis can significantly impact a woman’s life, including infertility, diligent treatment is necessary.
Who Gets Endometriosis?
Endometriosis has no direct cause and affects women and girls of all ages from puberty onward. The peak age of diagnosis is women aged 30-49.
Women often receive diagnoses later in life, not due to the condition manifesting at that age, but because endometriosis tends to be a progressive condition that worsens with time. Many more external circumstances lead to delayed diagnosis, such as normalization of period pain, dismissed symptoms, hormonal changes worsening symptoms during perimenopause, lack of awareness, masking by birth control, and discovery of fertility issues once a woman desires to become pregnant.
Do I Have Endometriosis?
There are many symptoms of endometriosis, and everyone’s unique experience with the condition can vary. Below are the most common, persistent symptoms patients with endometriosis experience regularly:
- Severe Pain – Intense, debilitating menstrual cramps that may worsen over time.
- Chronic Pelvic Pain – Pain in the lower back or abdomen that can last for 6 months or more.
- Painful Intercourse – Pain during or after sexual activity.
- Gastrointestinal Issues – Painful bowel movements, constipation, diarrhea, or nausea, particularly during menstruation.
- Urinary Pain – Pain with urination.
- Heavy or Irregular Periods – Bleeding that is excessively heavy or spotting between periods.
- Infertility – Difficulty getting pregnant.
- Fatigue – Extreme, constant tiredness.
Common Misdiagnoses for Endometriosis
Since there are a variety of symptoms that vary by person, endometriosis is a commonly misdiagnosed condition. Here are the most common misdiagnoses:
Gynecological Conditions:
- Fibroids
- Ovarian Cysts
- PCOS
- Pelvic floor dysfunction
- UTI
Other:
- Sciatica
- Gastrointestinal issues
- Firbomyalgia
- Appendicitis
How Do I Get Diagnosed for Endometriosis?
- Track Symptoms – Keep a detailed, date-indexed diary of your pain, cycle, and symptoms for up to 2-3 consecutive months.
- See a Specialist – Consult a gynecologist, as diagnosis requires specialized testing.
- Medical Tests
- Pelvic Exam – A doctor checks for cysts or scars and rules out other conditions.
- Ultrasound/MRI – Imaging to find endometriomas (cysts) or deep infiltrating nodules.
- Laparoscopy – The gold standard; a minor surgery to look inside the pelvis and take a biopsy of the tissue.
Treatments for Endometriosis in Wilmington, NC
Fortunately, there are more treatment options available today than ever before. A woman should discuss these options with her physician.
- Observation – This is usually a poor choice due to pain.
- Medical management – NSAIDS like ibuprofen and Naproxen are used to control the inflammatory symptoms of endometriosis. Narcotics are a poor choice to treat endometriosis.
- Hormonal treatments – These are first-line mainstays of treatment and include oral contraceptive pills, birth control rings, progesterone injections and oral progesterone.
- Hormonal suppression – The use of medications that suppress the normal hormonal cycle necessary for endometrial growth and proliferation.
- Depo Lupron is the older medication. While very effective, it causes significant menopausal symptoms.
- Orilissa is a newer medication available in two strengths: 150mg QD and 200mg BID. Both doses treat endometriosis with fewer side effects than Lupron.
- Surgical management – Diagnostic laparoscopy remains the only true way to diagnose endometriosis. Destruction or removal of the implants can be accomplished during the same procedure. Sometimes removal of a fallopian tube or ovary is necessary. Hysterectomy is considered only as a last resort.
Compassionate Care for Endometriosis in Wilmington, NC
As a physician who is board-certified in two women’s health specialties [obstetrics and gynecology (FACOG) and Female Pelvic Medicine & Reconstructive Surgery (FPMRS), also known as urogynecology], Dr. Robison has a great deal of experience and expertise treating women’s gynecological conditions, including endometriosis. Beyond his experience and expertise, he is proud to have a reputation for treating his patients with dignity and respect in addressing many common but sensitive issues.
If you are suffering from any of the symptoms of endometriosis or other GYN concerns, please call our office at (910) 509-0103 to make an appointment.