And how it’s connected to menopause.
Are you prone to really painful periods? Well, it might not just be part of your monthly cycle. And you might not see relief until you enter menopause. (Hey, menopause can have its benefits!)
A condition known as endometriosis affects about 2 to 10 percent of American women, and many of those who have it report chronic pelvic pain so severe that it can make even standing up a struggle.
“Many people with endometriosis don’t even know they have it, but those who do have it often have very painful periods,” says Rebecca Brightman, MD, our resident women’s health expert.
While symptoms tend to be more intense among younger women, it can affect those up until the age of 40 or until menopause. Dr. Brightman says what makes this condition difficult is it often takes years to diagnose because it’s often attributed to other problems and this delay could lead to other critical health conditions like cancer.
“It could take anywhere from 6 to 10 years to make a diagnosis,” she tells KCM. “A lot of people just brush it off as a painful period when in fact it’s not.”
To help us better understand this often debilitating disorder, Dr. Brightman breaks down the common symptoms and risk factors.
What is endometriosis?
This condition is where a tissue known as the endometrium, which normally lines the uterus, starts growing outside of it and spreads to other organs in the pelvis area, such as the fallopian tubes and ovaries. Though the cause remains unknown, your genes are thought to play a role, so if your mom has it, then there’s a chance you might too. A 2019 study also found that some women with endometriosis have immune system disorders, but there doesn’t seem to be a clear link between the two.
As for making a diagnosis, this can be tricky. It can only be confirmed through various medical tools, including a pelvic exam, ultrasound, a CT scan, or an MRI. There’s also a laparoscopy, which involves inserting a thin tube with a camera at the end into the abdomen by way of a small incision, so doctors can see exactly where the endometriosis is located and the extent of its growth. But in most cases, Dr. Brightman says many doctors want to avoid this kind of surgery, and patients can be usually diagnosed based on their clinical symptoms alone.
What are the endometriosis symptoms?
In addition to really uncomfortable periods, Dr. Brightman says some women can experience pain during sex, bleeding between their monthly cycles, trouble peeing, or just a sense of general discomfort in their abdominal area. Other signs include fatigue, diarrhea, constipation, bloating, or nausea.
But as John Hopkins Medicine notes, symptoms may not also indicate the severity of the condition because everyone experiences symptoms to varying degrees. Some women with it may experience no pain, while others may have a milder form of the condition. This is why Dr. Brightman recommends keeping a journal and making a list of any symptoms you’re experiencing, even the ones you don’t think are related.
What the relationship between endometriosis and menopause?
Endometriosis most commonly affects women between the ages of 25 and 45 years old who have menstrual cycles.
While this condition is scary, the good news is that symptoms may improve or completely resolve on their own during menopause, according to Dr. Brightman. This has to do with the fact that your body stops having periods, and produces much less of the hormone estrogen, which is vital for the tissue that causes the condition.
But just because you start menopause doesn’t mean symptoms will always go away. A 2009 study states, “the prevalence of endometriosis in post-menopausal females has been reported to range from 2-4% of women.” In a 2013 study, endometriosis was found in 22 percent of 903 postmenopausal women studied. While symptoms may subside, you should still stay up to date with doctors’ visits. Researchers from the 2013 study warn, “although postmenopausal endometriosis is usually benign, it is important to be aware of this condition, as it is increasingly recognized to have malignant potential.”
Though the cause remains a mystery, researchers think this uterus-like growth could be turned on later in life by your genes or something in your environment.
How is endometriosis treated?
It depends on a number of factors, such as age and your medical history.
While younger women with endometriosis are typically prescribed some form of birth control in combination with a pain medication, some health experts recommend that those who have the condition during menopause have the areas of endometrial tissue surgically removed. This has to do with some evidence that suggests that there are greater complications later in life with this condition, including the risk of the tissue spreading to other organs like the bowel or urinary tract.
On the other hand, if surgery isn’t an option, Dr. Brightman says your doctor might prescribe a reproductive hormone known as progesterone, which can help slow current or prevent new endometrial tissue growth.
Ultimately, you shouldn’t hesitate to contact your doctor if you suspect that you might have endometriosis because the condition can potentially lead to infertility in as many as 30 percent to 50 percent of cases.
It can also even increase your risk of certain cancers if left untreated.
“There’s some evidence that suggests that there may be an increased risk of ovarian cancer with endometriosis, so women should discuss this with their doctor,” warns Dr. Brightman.
The information provided on this site isn’t intended as medical advice, and shouldn’t replace professional medical treatment. Consult your doctor with any serious health concerns.