It’s not unusual for women with endometriosis to be diagnosed, treated with surgery, and still have pain because the treatment was ineffective. They often live with devastating pain because they’re told it’s been treated and there’s nothing else that can be done.
Thankfully, there are options. Although endometriosis can’t be cured, there are noninvasive and minimally invasive treatments that can help.
What Is Endometriosis?
During a woman’s normal menstrual cycle, tissue inside the uterus builds up, breaks down, and is shed from the body through your monthly flow. Endometriosis occurs when tissue similar to the tissue that lines the uterus (endometrium) grows outside the uterus on other pelvic structures, such as the bladder, ovaries or bowel. These endometriosis implants respond to monthly hormonal changes, but the tissue isn’t eliminated from your body. This causes pain, inflammation and scar tissue, which can eventually lead to damage of the reproductive organs.
Endometriosis can prevent you from becoming pregnant, and it can lead to bladder and intestinal problems. The pain can be so devastating it can affect every part of your life — intimate relationships, mood, work, school and other activities. For some women, it can progress from a few days of pain during menstruation to severe pain 24/7, with no relief.
In addition, diagnosis isn’t straightforward. In many cases endometriosis can’t be seen on an MRI, CT or ultrasound exam. These exams can identify some lesions of endometriosis, but they’re not sensitive enough to rule out the possibility of endometriosis conclusively. Laparoscopic surgery is the only method to determine with certainty if a woman does or doesn’t have endometriosis. This is one reason why so many women are misdiagnosed, and doctors underestimate the extent of the disease.
When to See a Doctor
Not all women experience severe symptoms, but for most women the symptoms get worse over time. The most common symptoms are severe pain during menstruation, during intercourse, or with bowel movements. Painful periods as a result of endometriosis usually get more severe over time, and the number of days of pain each month often increase to the point that it’s fairly constant. Other symptoms include:
- Digestive problems
- Difficulty getting pregnant
- Rectal bleeding
There’s a broad range of symptoms, and they vary from one woman to another. But, if you have debilitating pain, talk to a doctor who’s experienced in treating pelvic pain. It’s important to seek treatment so you can prevent the disease from worsening and damaging organs and pelvic structures.
Relief From Pain and Symptoms
Your treatment will depend on your symptoms and the extent of endometriosis. An experienced doctor will ask you about your symptoms and take the time to listen so he or she can develop a personalized plan. Noninvasive treatment may include:
- Integrative medicine and nutrition, which can help address the underlying inflammation and dysfunction that causes the disease
- Pain medicines
- Prescription medicines that change your hormone balance, such as birth control pills
For women with severe endometriosis, many doctors use a procedure that burns (cauterizes) the tissue during surgery to destroy it. But, this method rarely removes all the endometriosis. It may relieve pain for a short time or not at all. And, the condition often recurs. Some women undergo numerous surgeries without relief. A typical patient I see has had three surgeries and an average of 10 years of pelvic pain before seeing me.
I use a treatment I’ve found to be more effective: laparoscopic wide-excision surgery — often in combination with other, noninvasive treatments. This minimally invasive surgery removes the entire region around and under the area affected by endometriosis. Of more than 1,600 women who’ve come to me for wide-excision surgery, two-thirds report a 75 percent reduction in symptoms, and more than half report a more than 90 percent reduction in pain. For the vast majority of my patients, a single surgery has been sufficient to remove the endometriosis.
Wide-excision surgery can be an extremely complex procedure that requires advanced skill and precision to remove the endometriosis without harming the bowel, bladder, blood vessels and other vital structures. That’s why it’s so important to work with someone who’s a specialist in this type of surgery.
If you’re living with pelvic pain that hasn’t been diagnosed or you’ve received treatment but it hasn’t relieved your symptoms, there’s hope. Talk to your doctor to learn about wide-excision surgery and other advanced treatments.
El Camino Hospital offers complete care for women’s pelvic health, including the most advanced techniques to treat endometriosis.