A Chronic Inflammatory Disorder in Women

By OBGYN, Spencer Ferrell, MD

Overview

Endometriosis is a common chronic inflammatory disorder characterized by pelvic pain that affects many patients.  According to ACOG, endometriosis affects approximately 6-10% of patients of reproductive age and is prevalent in 20-50% of infertile patients and approximately 70-80% of patients with chronic pelvic pain. In this condition tissue that is found inside the uterus, the endometrium, forms outside of the uterus and can be found throughout the pelvis.  This disease is characterized by painful periods but may also impact fertility.

Endometriosis Symptoms

Symptoms of endometriosis include chronic pelvic pain (both during and outside of a menstrual period), painful intercourse, but may also affect how heavy periods may be as well as pain with urinating and bowel movements.  Some patients are asymptomatic and may find endometriosis incidentally when having surgery for another reason or during a fertility evaluation.  The definitive diagnosis of endometriosis is made through a biopsy during surgery, but evaluation always starts with a history and physical exam and often an ultrasound is performed.

Endometriosis Treatment

Treatment for endometriosis is individualized dependent on symptoms and pregnancy planning.  Medications are often used first and may help with pain, reducing symptoms, and slow and prevent further disease progression.  These medications include NSAIDs, hormonal medications such as birth control pill and hormonal IUDs, and newer hormonal modulators that all can help treat a patient.  Surgery may help remove endometriosis that can help with pain and improve fertility, but it may return.  In some cases, a hysterectomy may be recommended but medications may be used in addition to the surgery.

Endometriosis & Mental Health

Endometriosis is also associated with increased risk of anxiety and depression as well as may be associated with other causes of pelvic pain.  It is important to work with a healthcare team that is devoted to patient-centered care and aligns with a patient’s priorities.  The diagnosis of endometriosis can be challenging and it is a severe chronic pain disorder that can impact many aspects of a patient’s life. 

Establishing care with a gynecologist is a first step in developing an individualized treatment plan. Lakeview Clinic’s OBGYN team provides comprehensive patient centered care for endometriosis, and our physicians truly aim for pain-free lives for their patients.