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This month is Endometriosis Awareness Month and despite there being around 200 million people in the world who are diagnosed with the uterine condition, the signs and symptoms of Endometriosis (Endo) are often missed or overlooked entirely. Awareness months help change that

With awareness comes conversation, so we want to continue the discussion and talk about some commonly asked questions—and demystify misconceptions around Endo. 

Dr. Janelle Evans, is a Urogynecologist, double board certified subspecialty surgeon and Planned Parenthood Southwest Ohio Board member. 

Crystal Wilmhoff is the Assistant Medical Director for Planned Parenthood Southwest Ohio and a Certified Nurse Practitioner. 

Both experts will be weighing in on some Endo questions we wanted to shed light on:

What is endometriosis and who can get it?

“Endometriosis (en-doe-me-tree-O-sis) is tissue that is supposed to be inside the uterus that has made its way to other locations in the body. Most commonly, it is found on the tubes, ovaries, and at the bottom of the pelvis, but it can be anywhere (even the lungs).  The problem with endometriosis is that this tissue acts the same way as the endometrial lining with our menstrual cycles.  When the uterus bleeds during menstruation, so does this misplaced tissue.  This causes chronic pain issues that range from mild to debilitating and often can result in scarring inside the abdomen and pelvis because of the blood and inflammation occurring. 

Anyone can get endometriosis if you have a uterus and ovaries, however it is more prevalent in certain populations, such as women of reproductive age.” – Dr. Evans 

How is it diagnosed?

“Patients often complain of painful periods and other symptoms that occur during their period. These symptoms include pelvic pain and cramping, pain with bowel movements or urination, lower back or abdominal pain. Many patients report pain during or after sex. Other signs and symptoms are fatigue, diarrhea, constipation, bloating or nausea. Some patients have excessive bleeding or bleeding between periods (intermenstrual bleeding). Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility. Most of the time endometriosis is diagnosed and treated based on symptoms but a laparoscopy is the surgical procedure used to officially diagnose endometriosis.” – Wilmhoff

“Oftentimes, we start with a history of symptoms that is suspicious for endometriosis and try basic treatments prior to surgery, however, since it is often best treated with anti-inflammatory medications and hormonal suppression.” – Dr. Evans 

How common is it in our clinic?

“We see a lot of chronic abdominal and pelvic pain issues in a wide range of ages.  Usually these women have seen other physicians first prior to consulting a specialist, so we probably see a higher percentage of endometriosis patients than average.  In women between 25-45 with chronic pain, most will have some symptoms consistent with endometriosis.”—Dr. Evans

“About 1 in 10 patients complains of painful periods and most are looking to prevent pregnancy so we are able to use continuous birth control to help with both those issues.” – Wilmhoff

Why is an awareness month necessary/important to you?

“Endometriosis impacts up to 20% of people with a uterus and yet often patients are unaware that their painful periods are abnormal.” – Wilmhoff

“Firstly, as someone who has suffered a decent amount with endometriosis and having a mom that had major surgery due to it, I really have a vested interest in the research and progress we have made in diagnosis and treatment of endometriosis.  It is a common disease process with an estimated 10% of women having endometriosis, so having appropriate patient education and treatment options is key to success in managing the symptoms.” – Dr. Evans 

Can I grow out of endometriosis?

“Luckily, yes! The cyclical symptoms of endometriosis are linked to hormonal fluctuations, so menopause will solve that.  Once the ovaries are not functioning, regular inflammation and bleeding will stop gradually.  Any scarring inside the abdomen and pelvis is less likely to resolve, however, so it is still important to mention if you need surgery because scarring makes things more difficult.” — Dr. Evans

What are common treatments?

“Ibuprofen or naproxen during times that are particularly uncomfortable is the standard treatment.  Additionally, hormonal therapies such as birth control pills, progesterone based injections or IUDs are commonly used. Some people also need stronger hormonal control to put them in a medical menopause.  Surgery to remove the endometriosis and scar is sometimes performed, especially if the woman is having problems getting pregnant.  Removal of areas of endometriosis, however, is not permanent and is likely to reappear over months to years.  Regular surgery to remove endometriosis is generally not performed because it is not a cure, and should be reserved for severe symptoms and scarring.  The most surefire treatment for endometriosis, however, is removal of the ovaries since they control our hormones.  If the ovaries are removed, the endometriosis will subside, but there are definitely downfalls with removing the ovaries at a younger age.” — Dr. Evans 

Is there anything you would want to add that I didn’t ask?

“Chronic mild to severe pain especially with cycles, irritable bowel syndrome, bladder pain syndromes, overactive bladder, and depression are also commonly seen with endometriosis tend to be common in women with Endometriosis.” – Dr. Evans

What’s one thing you would want someone who thinks they may have endometriosis to know?

“The severity of their pain isn't necessarily a reliable indicator of the extent of the condition. They could have mild endometriosis with severe pain, or you could have advanced endometriosis with little or no pain and that endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. If treatment for these conditions does not work, continue to seek help.” – Wilmhoff

“Seek care and don’t suffer in silence.  Most gynecologists, urogynecologists, and infertility doctors have a lot of knowledge about endometriosis and can help make a treatment plan.” – Dr. Evans 

Endometriosis can be painful and hard to pinpoint, but if you or someone you love has a suspicion you may be struggling, don’t be afraid to seek out care! Schedule a checkup with us today. 

There are a wealth of options to mitigate Endo symptoms. 

Tags: endometriosis, awareness