Endometriosis pain?

When you should seek treatment

Endometriosis is a chronic condition that happens when tissue that normally lines the uterus grows outside the uterus. It’s common, especially among women in their 30s and 40s. The U.S. Department of Health and Human Services estimates it affects at least 5 million women in this country but also says many more probably have it but just don’t know it because they’re not experiencing any symptoms, most notably pain.

UT Southwestern gynecologist Ellen Wilson, M.D., notes that endometriosis can occur in four stages, with Stage 4 being the most severe.

“Many patients with endometriosis have just little bits of it and experience no symptoms, while others can have symptoms that range from severe pelvic pain and menstrual cramps to bleeding abnormalities,” says Dr. Wilson. “When we see endometriosis in adolescents, it’s usually Stage 1 or 2, although it can still cause significant pain.”

Patients of any age should seek an evaluation for endometriosis if their menstrual cramps or lower abdominal pain between periods is so severe that it’s not relieved with over-the-counter anti-inflammatory drugs, or when it’s interfering with daily activities.

After the diagnosis

If endometriosis is diagnosed, treatment is tailored to the individual. “We often put patients on an oral contraceptive pill, which in many cases takes care of cramps and abdominal pain,” Dr. Wilson says. “If that doesn’t help relieve a patient’s symptoms, we think about doing laparoscopic surgery—a minimally invasive procedure that enables us to remove the endometriosis—followed by use of birth control pills, progesterone, or some other formulation to hormonally suppress a recurrence of the condition.”

Women with severe endometriosis may elect to have a hysterectomy, which in most cases can also be performed with minimally invasive techniques, Dr. Wilson says.

To make an appointment with a UT Southwestern endometriosis specialist, call 214-645-8300.