Endometriosis

Cross-section of uterus with Fallopian tubes, ovaries, cervix, and vagina.

Endometriosis is a condition that occurs when the tissue that lines the uterus starts to grow where it should not. The tissue may grow on the outside surface of the uterus, the ovaries, or fallopian tubes. It may also grow on the bowel, rectum, bladder, or other areas. The tissue responds to the same hormones that control your menstrual cycle. So it may swell and bleed just like the lining of the uterus, which is shed every month during your period. The swelling and blood irritate nearby tissues. This causes pelvic or lower belly (abdominal) pain and cramping. The pain is often worse around the time of your period. Pain during sex is also common. Some women have pain during bowel movements or urination. Over time, scar tissue may form. This scar tissue can bind organs together. It can also cause problems getting pregnant (infertility).

The exact cause of endometriosis is unknown. The best way to confirm a diagnosis is with a procedure called laparoscopy. This allows the provider to look inside the abdomen with a small tube and light.

Treatment depends on your symptoms. If pain is mild, you may not need treatment. If pain is more severe, medicines may be advised. Surgery may also be an option. Your provider can tell you more as needed.

Home care

Medicines

To help manage endometriosis, any of the following medicines may be used:

  • Pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDS)

  • Hormonal medicines

    • Birth control pills

    • Progestin-only pills

    • Gonadotropin-releasing hormone (GnRH) agonists

    • Danazol

    • Aromatase inhibitors

If you’re prescribed medicines, take them as directed. Also report any side effects you have to your provider.

General care

  • Rest as needed when you have symptoms.

  • To help ease pain or cramping, apply a heating pad to where the pain is. You may also use a hot water bottle.

Follow-up care

Follow up with your healthcare provider, or as directed.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher, or as directed by your provider

  • Abdominal or pelvic pain or cramping gets worse, or doesn’t get better with medicines

  • Pain during sex, urination, or bowel movements continues

  • Heavy bleeding (soaking 1 pad or tampon every hour for 3 hours)

  • Missed periods (if they are usually regular)

  • Sudden, severe pain in the abdomen

  • Abdominal swelling with nausea or vomiting

  • Blood in the urine or problems urinating

  • Blood in the stool

  • Dizziness, weakness, fainting

Infertility

Note: If you have been unable to get pregnant after trying for 1 year, see your provider. They can talk with you about infertility testing.

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