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Endometriosis

Endometriosis a condition defined by the presence of endometrial-like tissue outside the uterus.

Endometriosis affects the lining of the pelvis (peritoneum), the fallopian tubes, the ovaries and the uterus. It could also affect other pelvic structures like the bladder, the bowels and the pelvic nerves, and could grow outside the pelvis, affecting the lungs, diaphragm, etc.…

1 in every 10 women is affected with Endometriosis during their reproductive years. Although it is a common condition, it is sometimes misdiagnosed or mistreated, taking up to 7 years from the onset of pain to diagnosis.

There are multiple risk factors for Endometriosis that have been identified, however this information must be treated carefully and with caution, as knowledge about the causes and development of Endometriosis is not yet definite. Research is still ongoing to determine what the causes may be.

These risk factors may include:

  • Family history of Endometriosis
  • Never having given birth
  • Short periods
  • Heavy and long periods
  • Low BMI
  • History of high estrogen production
  • Late menopause
  • Early onset of period
  • Reproductive system irregularities

Although sometimes people with Endometriosis can be asymptomatic, many people do experience painful and uncomfortable symptoms, such as:

  • Painful periods
  • Pelvic pain throughout the cycle
  • Intestinal pain
  • Fatigue and unease
  • Painful sex
  • Difficulty conceiving and infertility
  • Painful urination or bowel movements
  • Blood in urine or bowel near the time of menstruation
  • Pain radiating into back, down legs, and sometimes into chest
  • Shoulder and neck pain
  • Fatigue
  • Dizziness with cycle
  • Recurring constipation/diarrhea

To identify and diagnose Endometriosis, we can perform the following examinations:

  • Pelvic examination
  • Ultrasound
  • MRI
  • Laparoscopy

Endometriosis can be classified in stages:

  • Stage One: Minimal Endometriosis

Characterized by minimal superficial lesions and no significant adhesions

  • Stage Two: Mild Endometriosis

Characterized by superficial and deep lesions with no significant adhesions

  • Stage Three: Moderate Endometriosis

Characterized by multiple deep lesions, small cysts on ovaries, and translucent adhesions

  • Stage Four: Severe Endometriosis

Characterized by severe and multiple deep lesions, large cysts on ovaries, and dark adhesions

These stages are based on the location, adhesions, spread, and depth of the Endometriosis and will be determined by your doctor upon examination.

If you have been diagnosed with Endometriosis, there are different treatment options, depending on the stage, symptoms and condition. For some people this disease is manageable, while for others, it is debilitating and causes disruption of daily life and routines.

Treatment can include painkillers for mild conditions, or a minimally invasive surgical excision of Endometriosis.

Endometriosis excision is when the endometriotic lesions are removed surgically while preserving the uterus, fallopian tubes, and ovaries. This type of minimally invasive surgery is the most effective treatment for Endometriosis, and should only be done by trained specialists.

People with severe deep infiltrating Endometriosis benefit highly from excision surgery. The improvement after this procedure for people with such cases is usually striking and highly successful.

Other treatments for Endometriosis include:

  • Pelvic floor physiotherapy
  • Pelvic floor Botox
  • Change in diet
  • Acupuncture
  • Assessing and avoiding environmental triggers

Call us or request an appointment with Dr. Gaby Moawad to address your condition.

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