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End Endometriosis Pain

Often painful and without a straightforward cure, endometriosis can affect women of almost every age. But there’s hope for pain relief and preserving fertility.

Updated December 29, 2019

Endometriosis is a common disease that occurs in women when the endometrial lining, a group of cells that normally line the inside of the uterus, are found in other parts of the body outside of the uterus. Rather than being discharged as a period, it’s believed that some of the endometrial lining may travel backward through the fallopian tubes and attach like scar tissue to the ovaries, the outside of the uterus, the surface lining of the pelvis, or the large or small intestines.

According to Stuart Shalit, DO, chair of the department of obstetrics and gynecology, Virtua North campus, it’s important to understand the warning signs and symptoms of endometriosis, and to know that there are several treatment options available if you’re diagnosed with this condition.

Signs and Symptoms
"Classic symptoms of endometriosis include unusually painful periods, chronic pelvic pain, or pain during intercourse," says Dr. Shalit. It’s also possible to have endometriosis and not experience symptoms (this is called asymptomatic endometriosis), or to have fertility issues related to asymptomatic endometriosis, which isn’t found until a woman is trying to get pregnant. "The severity of symptoms is also not the best indicator of the severity of the condition," Dr. Shalit points out. Meaning: You can have a very mild case of endometriosis and experience a great deal of pain, and at the other end of the spectrum, you can have a more severe case and not experience severe symptoms. 

It’s extremely important to be forthright with your doctor about what you’re experiencing. "Periods are commonly painful, and pain, of course, can only be measured subjectively, but a woman should be on alert and notify her doctor if the degree of discomfort has worsened significantly," says Dr. Shalit. "That should raise a red flag, and that’s cause for further investigation."

Women should also keep in mind that endometriosis can occur at any time from the first menstruation on through menopause. "Endometriosis can happen to teenagers, to women in their 20s, 30s, 40s...though, generally speaking, endometriosis diagnosed in an older, perimenopausal woman is usually suspected to have started earlier on," says Dr. Shalit.

Treatment Options
Treatment options for endometriosis range from over-the-counter analgesics (to manage pain) and birth control pills (to thin the endometrium) for moderate cases, to leuprolide (also known as Lupron) injections and surgical procedures for more severe symptoms.

"If the first line of treatment fails, the next step is a laparoscopic procedure (minimally invasive surgery to view the inside of the pelvis) to allow the doctor to visually confirm the diagnosis. Often the surgeon will remove the excess endometrium during that same procedure," says Dr. Shalit. "The goal is to keep the treatment as minimally invasive as possible, and to address fertility concerns for any woman desiring to have a child."