Endometriosis is a painful condition that causes the endometrium to grow outside of the uterus. I have been diagnosed with stage one endometriosis; there are four stages. This article will explain what endometriosis is, what the symptoms are, treatments, and how I found out I had stage one of endometriosis.
What is endometriosis?
Endometriosis is a disease caused by endometrium tissues that grow outside of your uterus and around your organs. They most commonly grow around ovaries, fallopian tubes, and tissues lining your pelvis. Endometrium tissues become trapped because they thicken during your menstrual cycle, resulting in cysts called endometriomas. The surrounding tissues become irritated and later result in scar tissue, leading organs to stick together. Overall, it is very painful and may lead to infertility.
Common Symptoms
Painful periods (dysmenorrhea)
You may experience pelvic pain before you menstruate, during, and several days after you've finished menstruating.
Pain with intercourse
It is common to experience discomfort and pain during or after intercourse. The reason for the pain is you have irritated endometrium tissues.
Pain with bowel movements and urination
It is common to have pain while having a bowel movement or urinating; you are using your bladder and rectum muscles which contract when used, resulting in pain. This is mostly caused by endometrium tissues. You may find it worse when you are menstruating.
Excessive bleeding
You may find that your menstrual cycle is heavy (menorrhagia) or you may bleed between menstrual cycles (menometrorrhagia). You may also experience blood clots.
Infertility
You may not have symptoms of endometriosis if it is discovered when you are trying to conceive. Endometriosis can cause infertility.
Other symptoms
Some other symptoms you may experience include bloating or nausea, fatigue, diarrhea or constipation.
Treatments
Pain medication
The first action in managing the pain is to take a combination of anti-inflammatory drugs like ibuprofen (Advil or Motrin) and naproxen (Aleve). The combination of both medications is to reduce inflammation and ease pain. Taking just naproxen alone won't be effective because it doesn't have the anti-inflammatory agents to combat the swelling and irritation.
Hormone therapies
Hormone therapies are beneficial for people suffering from endometriosis. They cannot cure endometriosis, but they can greatly improve quality of life.
Contraceptives
Contraceptives can slow down or completely stop menstrual cycles, thus, decreasing pain overall.
Gonadotropin-releasing hormone (Gn-RH)
The Gonadotropin-releasing hormone, or Gn-RH, works to stop the production of estrogen in the body to eradicate pain caused by endometriosis. This hormone is available in daily, monthly, or three month injections or a nasal spray. Most people see improvement in several weeks, but it can get worse before it gets better. Bleeding often stops within two months, though there can be some spotting.
Progestin therapy
Progestins are known for acting similar to progesterone, and have been used since the 1950s to treat symptoms of endometriosis. They are thought to stop growth of the endometrial implants, thus stopping menstruation and ovulation.
Invasive surgery
Minimally invasive surgery is to reduce trauma to the body with small incisions by using thin needles and an endoscope. This procedure is beneficial because it allows surgeons to look at the outside of organs without causing too much trauma to the body. The endoscope allows the surgeon to see from the camera so the surgeon can guide it around the organs.
My experience with treatment and diagnoses
It can be very frustrating to not know what to do or how to handle the constant pain; I was frustrated and felt helpless. The treatment I was given from the beginning was a combination of over the counter medication. The combination I took was, Tylenol (acetaminophen), used for pain relief, and Advil (ibuprofen) which reduces inflammation. Aleve (naproxen) also decreases inflammation. It is recommended to take a form of birth control to reduce the pelvic pain. I was sent for ultrasounds to see if they were able to see anything, but ultrasounds aren't able to detect endometriosis as they are cells. I switched birth control pills when I was unable to handle the pain. My OB suggested injection therapies and to induce pre-menopause. The injection, Lupron, is injected once a month in your buttock where it releases the hormone, leuprolide acetate, a synthetic gonadotropin-releasing hormone, throughout the month. Lupron puts you into menopause, which means you won't get a period or ovulate; Lupron puts the female reproductive system in sleep mode. The purpose for this treatment is to stop menstruation as this is the cause of severe pelvic pain and heavy menstrual cycles. The typical recommended treatment length is six months, however, I stopped the Lupron treatment and the pelvic pain returned with heavy painful menstrual periods. I went back on Lupron after a surgeon approved me for surgery to explore my reproductive organs. The surgery found endometrium tissue, which was then tested.The tissue came back positive for endometriosis stage one. I continue to receive treatment to stop my menstrual periods.
Everyone's experience with endometriosis is different as our bodies work differently and respond to pain differently.
Healthcare support
It is important to have a lot of healthcare support so you aren't left feeling lost and alone, which I felt at the beginning. It is hard to have the right fitting health team on your side; not all doctors believe endometriosis is a condition so I had to be proactive and fight for my female organs.
My healthcare support team consisted of my family doctor, pain doctor, nurses, and a gynecologic surgeon. I found having a healthcare team lessened my anxiety. They understood the type of pain I was in; they listened and talked to me with passion.
Treatment plan
My treatment plan consisted of both pain treatment and hormone therapies. During my treatment plan, I was also receiving medical support in managing my symptoms. I also received therapy for pain management to handle the symptoms of pain, talking about what was going on really helped me. The hormone therapy I used were birth control pills which didn't help me, then I was given a stronger medication called Lupron to stop my menstrual cycle and to induce menopause. By doing this, my reproductive organs would not ovulate or have a menstrual cycle, this allows the endometrium tissues to stop growing and causing pain. I then received surgery to explore my reproductive organs, which consisted of both the treatment and diagnosis of endometriosis.
Surgery
It was hard to have another surgeon say I didn't qualify for a minimally invasive surgery, also called a laparoscopic surgery. I later found a surgeon who agreed to do the surgery. A laparoscopic surgery is where they make tiny little incisions in your abdomen and fill your stomach with air. They use cameras and tools through those small incisions to investigate. They first look at your organs (kidneys, liver, colon, lungs, diaphragm) then they travel to your bladder and female reproductive organs.
Sources
http://www.mayoclinic.org/diseases-c...e/ovc-20236421
http://endometriosis.org/treatments/progestins/
http://endometriosis.org/treatments/gnrh/
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