What is endometriosis?

 

There are 3 layers of the uterus:
• Outer layer called serosa
• Middle layer called myometrium

• Inner layer called endometrium

 

Every month when you have your period, the endometrium is shed. Sometimes the endometrial tissue grows in other places in the body. When this happens, you can get a condition called endometriosis. It is a lifelong disease.

 

If you have endometriosis, you can find endometrial tissue on:

• Ovaries

• Fallopian tubes

• Surface of the uterus

• Cul-de-sac (the space behind the uterus)

• Bowel and rectum

• Bladder and ureter (the tube that connects your kidneys to your bladder)

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If you have endometriosis, when you have your period every month, these spots of tissue outside the uterus can also bleed a small amount. Over time, this can cause the pelvic organs (like the uterus, ovaries, tubes, bladder and rectum) to stick together or you might develop a cyst on your ovary called an endometrioma. Over time, this can become painful. For some women, this can also cause problems getting pregnant.

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How do I know if I have endometriosis?

 

If you have endometriosis, you might experience:

• Painful periods
• Pain with sex
• Pain or blood with bowel movements

• Pain or blood with urination
• Difficulty getting pregnant

 

 

How is endometriosis diagnosed?

 

Sometimes, endometriosis can be suspected based on your symptoms and a physical examination. You can start treatment for possible endometriosis without doing any other tests. Your doctor might get you to do an ultrasound to see if there are cysts on your ovaries or if there are signs of endometriosis. Endometriosis is often not seen on ultrasound unless you have severe disease and/or endometriomas.

 

The only way to know if you have endometriosis is with a surgery called laparoscopy (also known as keyhole surgery). Small incisions are made on your abdomen and a thin telescope with a light (called laparoscope) is put into your abdomen through the small incisions. This lets your doctor to look at your pelvic organs

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The severity of your symptoms does not always equal the severity of the disease. You might experience a lot of pain but your doctor might only see mild disease. On the other hand, you might have only a little pain, but your doctor might see very severe disease.

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I have endometriosis. What medications can I use to treat my symptoms?

 

Treatment of endometriosis depends on how bad your symptoms are and if you want to have children. Most women need long-term treatment to control symptoms because symptoms might come back if medications are stopped.

 

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You should talk to your doctor to see what medication is best for you and what the side effects are.

 

 

I am having difficulty getting pregnant. What should I do?

 

There are many reasons why you might be having difficulty getting pregnant. A fertility specialist can help you gure this out. If you have mild endometriosis, surgery to remove your endometriosis might help you get pregnant. If you have severe endometriosis, you might need in vitro fertilization (IVF) to help you get pregnant.

 

 

Can I have surgery to remove the endometriosis?

You should consider surgery if:

• You have tried medication and it is not working

• You have symptoms from your endometriosis but cannot take

  medication because you want to try to get pregnant

• You have serious complications to your bowels, bladder, or

  ureters from endometriosis

• You have infertility and your doctor recommends surgery

 

Surgery can be done to remove endometriosis and the scarred tissue around it. Surgery is usually done by laparoscopy (keyhole surgery). At this hospital, your doctor will usually use a tool called a laser to cut out the endometriosis.

 

After surgery, you may have relief from pain. But, for many women, the pain will return. There is a 50% chance of the
pain returning within 5 years after surgery. Your doctor might recommend medications to prevent your endometriosis from coming back so you can have a longer time period without pain.

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If you do not want children and your pain is severe, you can consider a hysterectomy. This is the removal of your uterus. This might help better control your pain.

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What else can I do to control endometriosis?

 

Some believe that changing your lifestyle can help treat your endometriosis. There is no scienti c evidence to support this but there are also no known harms.

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Diet

A macrobiotic diet, such as eating whole grains, vegetables, beans and lentils, can help control the endometriosis. You can also have sh, seafood, seeds and nuts. You should avoid processed foods, milk, cheese, red meat, and re ned sugar.

 

Qigong

This is a traditional Chinese practice of body movement, meditation, deep breathing and a calm state of mind. You can ask your doctor for more information on Qigong classes.

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Who do I contact if I have questions?

If you have any questions or concerns, please call your gynecologist’s o ce.

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Sunnybrook Health Sciences Centre

2075 Bayview Avenue Toronto, ON M4N 3M5

Telephone: 416.480.6100

www.sunnybrook.ca
PR 47185 (MAR 2016)

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