When Pain is More Than Just a Monthly Visitor
I never knew when it would hit me. This time I was standing in front of my class of 28 third graders teaching a reading lesson. The pain was excruciating – like someone taking a knife and twisting it into my side. Quickly I turned away and bit my lip, trying to catch my breath without alarming my students. After what seemed like minutes, the pain subsided, and I let out a slow breath before resuming the lesson.
For months I endured this unpredictable yet excruciating pain. It was infrequent enough at first to ignore it but coupled with the fact my husband and I had been trying to get pregnant for several months, I decided it was time to see a doctor.
After seeing two different doctors and having a surgical procedure called a laparoscopy, I was diagnosed with endometriosis—a condition where tissue similar to the lining of the uterus grows outside the womb. Endometriosis is more than just a medical term; it’s a daily struggle that affects approximately 1 in 10 individuals of reproductive age globally.
The Unseen Pain: Understanding Endometriosis
Endometriosis manifests in various ways, but one of its hallmark symptoms is debilitating pelvic pain. This pain can surface during intercourse, bowel movements, and even mundane activities. It can be occasional pain like mine, or relentless pain causing you to cancel plans, call in sick to work, or explain to friends and family why you can’t participate in activities. This is a daunting reality for those living with endometriosis.
Beyond the physical pain, endometriosis can significantly impact mental health. The constant battle with pain, coupled with the uncertainty and frustration of seeking a diagnosis and effective treatment can lead to anxiety, depression, and feeling of isolation.
Connecting: Endometriosis and Infertility
Although it is not always connected, almost 4 in 10 women with infertility also have endometriosis. Endometrial tissue can implant around the ovaries or fallopian tubes, which can damage the sperm or egg or prevent them from moving properly through the fallopian tubes or uterus, sometimes blocking the tubes altogether because of adhesions or scar tissue. It has even been shown to alter the immune system, alter the hormonal environment around the eggs as well as the quality of the eggs. Tissue can also implant on other organs in or even outside the pelvis.
If you have symptoms of endometriosis and are struggling to get pregnant, see a reproductive endocrinologist or gynecologist.
Navigating the Journey: Diagnosis and Challenges
An OBG-YN may first do a pelvic exam and order an ultrasound or MRI. Although this does not confirm endometriosis, it can highlight cysts which are sometimes caused by the disease.
The only way to properly diagnose endometriosis is through a surgical procedure called a laparoscopy. A thin, lighted telescope is inserted into a small incision allowing the doctor to view affected organs and/or take a biopsy to be observed under a microscope. The advantage of a laparoscopy is that endometriosis can often be diagnosed and treated during the same procedure depending on where the scar tissue is found and the extent of the damage. If damage is found in other organs, additional surgery may be required. Often, the surgeon can remove cysts or scar tissue during the laparoscopy, resulting in a decrease or even elimination of pain. Studies have shown that five years after surgery, up to 70 percent of women will have no evidence of endometriosis returning.
As with any surgery, there are risks. Your doctor will go over those risks and together you can decide which course of treatment is required. Pain medications or hormone therapy are other options for treatment. Due to the hormone fluctuations during the menstrual cycle, endometriosis causes tissue to thicken, break down, and bleed. Hormones may slow the growth of this tissue and prevent new tissue from forming; however, symptoms may return when treatment is stopped.
Patients who are struggling to get pregnant may be referred to a fertility specialist to discuss other treatment options to preserve and improve fertility.
Empathy and Support
Endometriosis is not just a condition that affects your physical health. Emotional support, education, and self-care strategies are vital to managing this condition. Finding others through support groups or online communities can help someone living with endometrial pain navigate life, share experiences, tips, and coping mechanisms and together seek out healthcare providers who specialize in endometriosis.
If you or someone you know is dealing with endometriosis, remember, you are not alone. Seek support and never hesitate to advocate for yourself. Feel free to contact us if you need a listening ear or help with finding a healthcare provider in our area.
Resources
- The American College of Obstetricians and Gynecologists. (2020). Endometriosis Fact Sheet
- The Endometriosis Foundation of American. (n.d.). Understanding Endometriosis
- National Institute of Child Health and Human Development. (2021). Endometriosis: Overview.
- Massachusetts General Hospital. (2023). Endometriosis and Its Impact on Fertility
- Mayo Clinic. (2021). Endometriosis: Symptoms & Causes