Endometriosis is a condition in which tissue similar to the lining of the uterus (the endometrium) grows outside the uterus. Endometriosis most commonly involves the ovaries, fallopian tubes, and the tissue lining the pelvis. Rarely, endometrial-like tissue may be found beyond the area where pelvic organs are located. With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down, and bleeds with each menstrual cycle. But because this tissue has no way to exit the body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
During a pelvic exam, your doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often, however, it's not possible to feel small areas of endometriosis unless they've caused a cyst to form.
This test uses high-frequency sound waves to create images of the inside of your body. To capture the images, a device called a transducer is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Standard ultrasound imaging doesn't definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
An MRI provides detailed images of your organs and tissues using a magnetic field and radio waves. This test can help your doctor identify endometriosis implants, especially those that are deep within your tissue.
In some cases, your doctor may refer you to a surgeon for a procedure that allows the surgeon to view inside your abdomen (laparoscopy). While you're under general anesthesia, your surgeon makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for signs of endometrial tissue outside the uterus. A laparoscopy can provide information about the location, extent and size of the endometrial implants. Your surgeon may take a tissue sample (biopsy) for further testing.
This blood test measures a protein called CA-125, which is found in higher concentrations in people with endometriosis. However, this test isn't definitive, as CA-125 can be elevated for many reasons, and some people with endometriosis have normal CA-125 levels.
Over-the-counter pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help ease painful menstrual cramps. If these don't help, your doctor might prescribe stronger pain medications or refer you to a pain specialist.
Supplemental hormones can sometimes be effective in reducing or eliminating the pain of endometriosis. Hormone therapy helps your body regulate the monthly hormonal changes that promote the tissue growth that occurs when you have endometriosis. Options include hormonal contraceptives, gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, progestin therapy, and aromatase inhibitors.
If you're having difficulty becoming pregnant, your doctor may recommend fertility treatment, which could include fertility medications to stimulate ovulation or assisted reproductive technologies, such as in vitro fertilization, to help you become pregnant.
Applying a heating pad, hot water bottle, or taking a warm bath can help relax pelvic muscles and reduce pain. Some people find alternating between heat and cold provides relief.
Physical activity may help ease pain and improve symptoms. Low-impact exercises like walking, swimming, or yoga can be particularly beneficial. Exercise helps by improving blood flow, reducing estrogen levels, and releasing endorphins, which are natural pain relievers.
Some research suggests that certain dietary choices may help manage endometriosis symptoms. Consider reducing intake of red meat, trans fats, and foods high in caffeine and alcohol. Increasing consumption of fruits, vegetables, whole grains, and foods rich in omega-3 fatty acids may help reduce inflammation.
Stress can worsen endometriosis symptoms. Techniques such as deep breathing, meditation, yoga, and progressive muscle relaxation may help manage stress and reduce pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce pain and inflammation. Take them as directed, and consult with a healthcare provider if you need to use them frequently.
A minimally invasive procedure where the surgeon removes endometriosis implants while preserving the uterus and ovaries. Small incisions are made in the abdomen, and a thin tube with a camera (laparoscope) is inserted to guide the surgeon in removing endometrial tissue. This approach is often recommended for women who want to become pregnant or experience significant pain despite other treatments.
A surgical procedure to remove the uterus, and sometimes the ovaries and fallopian tubes as well. This is considered a last resort for women who have severe symptoms, haven't responded to other treatments, and don't want to become pregnant. It's important to note that even with a hysterectomy, endometriosis may still recur if some endometrial tissue is left behind.
A more invasive surgical procedure involving a larger incision in the abdomen to remove endometriosis implants, cysts, or scar tissue. This approach might be necessary for severe or extensive endometriosis that can't be adequately addressed with laparoscopy.
If you're experiencing symptoms of endometriosis, our expert team is here to help you find the right treatment approach for your specific needs.