Endometriosis, an often painful condition in which tissue similar to the lining of the uterus (the endometrium) grows outside the uterus, is the bane of some 176 million (about 10 percent) women of reproductive age worldwide. Endometriosis lesions may be found anywhere in the pelvic cavity, including the ovaries, fallopian tubes, peritoneum, and the rectal-vaginal septum. Though not as common, lesions can also appear on the bladder, on C-section scars, on the rectum, and other areas.
In addition to pelvic pain, which often, but not always, takes the form of painful periods, endometriosis, left undiagnosed or untreated, can wreak havoc on a woman’s reproductive system, causing infertility in 30 to 40 percent of women of child-bearing age.
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According to Martin Keltz, MD, a reproductive endocrinologist at WESTMED Medical Group, “We’re not making the diagnosis as often as we did 10 or 15 years ago, because more and more patients who are having fertility problems will go right to IVF.” In order to make a diagnosis, Keltz says, “You need to do a laparoscopy and a biopsy; that’s the gold standard.” Without a proper diagnosis, other conditions, such as a benign corpus luteum cyst, “which will often go away on its own,” can be mistaken for endometriosis.
For women with a definitive diagnosis, there are some effective drugs to treat the condition. Though Lupron, which was standard 20 years ago, is still sometimes used, Keltz says that the side effects include a decrease in bone mass and vaginal dryness.
Norethindrone Acetate, a progestin that is taken orally, is another treatment. “There are newer drugs, called estrogen blockers, which are effective, but the side effects are too extreme,” says Keltz, adding, “One of the most promising new treatments is Merina, a progesterone IUD that lasts for five years.”
For more information on endometriosis, visit www.endometriosis.org.
