Pelvic pain: could it be endometriosis?

Many Americans know the pain of endometriosis. In fact, this condition affects about 10 million women, most under the age of 40.  

What is endometriosis?

Endometriosis is a condition where cells from the uterus grow outside of the womb. Clumps of this tissue will sometimes grow on fallopian tubes, ovaries, intestines or other nearby organs.

While some people have the condition without any symptoms, it usually causes pain in the pelvic area — the lower gut, groin or rear. Other common symptoms include:

• Pain during sex.
• Bloating.
• Menstrual periods that vary in length and flow.
• Difficulty getting pregnant.

It typically affects women in their 30s and 40s. Other than age, a few factors that raise your risk for the condition are:

• Starting your period before age 11.
• Family history.
• Never having been pregnant or given birth.
• Starting menopause after age 52.

Identifying endometriosis

Finding out if it’s endometriosis can be tricky. There are other conditions that cause many of the same symptoms.

Your doctor may first rule out other possible causes.

“The gold standard for confirming endometriosis is exploratory laparoscopic surgery (a minimally invasive way to see inside the body). That’s why it’s not often diagnosed early,” says Emily Downing-Moore, CNM, a PeaceHealth certified nurse midwife in Florence, Oregon.

While there are no known causes, experts note a few preventive measures. Lowering inflammation in your body may help. Your immune system uses inflammation to defend against infections, but long-term inflammation can cause pain and problems in many parts of the body.

Recent studies have also showed breastfeeding can improve endometriosis symptoms.

Treating endometriosis

“Endometriosis is considered a chronic inflammatory condition, and currently there is no definitive cure,” Downing-Moore says.  

A few medications may help with symptom control.

Hormonal medications such as oral contraceptives can help slow the growth of the endometrial tissues and possibly keep new sticky clumps (adhesions) from starting. But they don’t affect what is already present, Downing-Moore says.  

Medications called GnRH agonists are also an option. “These suppress the production of estrogen in the body which can help alleviate symptoms and reduce the growth of endometrial tissue. until you stop using the medication,” she says. Because this type of medicine can cause similar side effects associated with menopause, it’s not the first kind of treatment to try.  

If medications aren’t effective, some people opt to have their uterus (and possibly their ovaries) removed.

At-home measures

There are at-home measures you can try to reduce inflammation and ease your symptoms. A heating pad, ice pack or massage could help you feel better.

In addition, see if there are any activities, conditions or substances that make your symptoms feel worse. Consider those your triggers. For example, some people find it helpful to avoid drinking alcohol or emptying their bladder before it gets full.

Seek help

“You might think you just have to live with painful or heavy periods. It doesn’t have to be that way. Ask your provider if things don’t feel right,” says Downing-Moore.

If you’re having pelvic pain or other symptoms noted above, keep a journal. Track how you’re feeling. Take note of anything that makes you feel worse or better.

The more information you can share with your provider, the better able they will be to help you.