March is Endometriosis Awareness Month. Endometriosis is a complicated disease in which tissue similar to the tissue that lines the uterus grows in other parts of the body. Typical sites include areas of the abdomen, such as on the ovaries, on the fallopian tubes, in the pelvic cavity, and on the ligaments supporting the uterus. The lining of the uterus reacts to changes in a woman’s cycle by growing, breaking down, and then shedding through the vagina as a woman’s menstrual period. In a similar manner, the endometriosis tissue also reacts to a woman’s cycle by growing and then breaking down. But in this case there is no way for the tissue to be shed out of the body, resulting in the development of inflammation and possible scarring. This inflammation and scarring can then cause pelvic pain and infertility.
Endometriosis is very common, affecting approximately one in ten women of reproductive age. Despite, this, it is under-diagnosed and poorly understood. One of the reasons endometriosis is difficult to diagnose is because the symptoms can often be mistaken for something else. Symptoms include: pain with menstrual periods (before and during), pain with intercourse, gastrointestinal difficulties (diarrhea, constipation, nausea), and infertility. The symptoms of endometriosis can appear differently in each woman with the disease–another reason it may not be diagnosed.
Endometriosis is a chronic disease, meaning there is no cure, but there are treatment options available. The cause of endometriosis is unknown. Treatment may include: pain medication, hormonal treatment to stop ovulation, and surgery. There isn’t one single treatment that is effective for all women with endometriosis, and some women still experience symptoms even with treatment.
For many women, painful intercourse and infertility are the most distressing symptoms of endometriosis. These two conditions can contribute to depression, anxiety, low self-esteem, and relationship stress. Endometriosis can severely impact a woman’s quality of life.
If you suspect that you have endometriosis, the first step is to talk to your doctor. Because endometriosis is under-diagnosed, you may need to be persistent to find a doctor who can give you a diagnosis. Keep at it! Painful intercourse and severe pain with your period are NOT normal! You may also find it helpful to see a sex therapist for support on the emotional and relational impacts of endometriosis. Anxiety, depression, relational stress, infertility, and painful sex are all topics that a sex therapist can help you with. No one should have to live with the pain and distress caused by endometriosis, but at least you don’t have to be alone as you navigate your treatment options.