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Understanding Endometriosis


Endometriosis is a common condition, affecting 10-20% of women. With symptoms that include pelvic pain, painful periods, pain with intercourse, and pain with urination or bowel function, it can be a severe, life-altering condition.


What is Endometriosis

The condition occurs when the endometrial cells, which normally line the uterine cavity, are outside the uterus and in the peritoneal cavity, where the tubes, ovaries, and intestines are located.

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 diagnosis 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 your mother or sister has endometriosis.

Because endometriosis can significantly impact a woman’s life, including infertility, diligent treatment is necessary.


There Is Hope

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 diagnosis 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 the last resort.


Exceptional Credentials and Compassionate Care

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], I have a great deal of experience and expertise treating women’s gynecological conditions, including endometriosis. Beyond my experience and expertise, I am most proud of my reputation for treating my 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 ASAP.