Q: My granddaughter who is rather young has been diagnosed with endometriosis. Can you tell me what she is in for in the future and if she can plan on overcoming the condition in the near future?
A: Endometriosis is a disorder in which the cells that line the uterus grow outside their designated area in the uterine cavity, most often on the membrane that lines the abdominal cavity. Women diagnosed with endometriosis have tissue that acts as it should in a healthy individual – it thickens, breaks down and bleeds during each menstrual cycle. However, because the displaced tissue is prevented from leaving the body, it becomes trapped, causing the tissues surrounding it to become irritated. Scar tissue and adhesions form and pain occurs. In fact, the most common symptoms of endometriosis are pelvic pain and infertility. The condition is commonly diagnosed during a female’s reproductive years, yet it has also been diagnosed in some children as young as eight and can continue past menopause which often occurs when a woman is in her 50s.
Signs and symptoms may include infertility, bloating, fatigue, diarrhea, constipation, and nausea. There may be occasional menstrual cycles that cause heavier than normal bleeding.
Women with the condition are known to differ in the degree of pain experienced. Some pain may be mild and quite tolerable, while other individuals may suffer severe cramps in the pelvic area, and less commonly in the lower back, rectum, and down the legs. Surprisingly, endometriosis has been found to occur in between four and 10% of all women.
Individuals at an increased risk include those who have never had a child, have abnormalities of the uterus, have a family history, or who have had pelvic infections in the past. There is no cure; however, there are treatment methods offered that may include pain medication, hormonal treatments and surgery. In fact, depending on the severity of symptoms, treatment may include over-the-counter pain relievers such as NSAIDs (non-steroidal anti-inflammatory drugs), hormone therapy in the form of a vaginal ring, birth control pills or patches, injectable drugs, or lastly – surgery. For those with extreme pain who undergo surgery, the downside is that both the endometriosis and the pain may return in the future.
As with many conditions, endometriosis may be mistaken with such conditions as irritable bowel syndrome and pelvic inflammatory disease – both of which can cause similar symptoms. Therefore, testing that begins with a pelvic examination will likely be followed by an ultrasound. While the ultrasound won’t specifically indicate whether a woman has endometriosis, it will identify cysts or other abnormalities of the uterus.
Your granddaughter should be under the care of a gynecologist she feels comfortable with. She will likely be treated with conservative measures initially that may require more aggressive measures in the future.
