For millions of women, painful periods and pelvic discomfort are just part of life. But what if that pain is a sign of something more? Endometriosis is a common but often misunderstood condition that affects about one in 10 women of reproductive age. Despite its prevalence, many women go years without a diagnosis, suffering in silence.
We spoke with Dr. Ali Ghomi, a recognized leader in minimally invasive gynecologic surgery at St. Joseph’s Health to break down everything you need to know about endometriosis, from what causes it to how it can be treated.
We spoke with Dr. Ali Ghomi, a recognized leader in minimally invasive gynecologic surgery at St. Joseph’s Health, to break down everything you need to know about endometriosis, from what causes it, to how it can be treated.
What Is Endometriosis?
Endometriosis is a condition in which tissue similar to the lining of the uterus (endometrium) grows outside the uterus. This tissue can attach to the ovaries, fallopian tubes, and other pelvic organs, leading to inflammation, scarring, and pain.
“Endometriosis is not just bad period cramps,” explains Dr. Ghomi. “It’s a chronic condition that can affect every aspect of a woman’s life, from her ability to work and exercise, to her chances of getting pregnant.”
What Are the Signs and Symptoms of Endometriosis?
Endometriosis symptoms can vary widely, and their severity varies from woman to woman. Some women may have mild symptoms, while others experience debilitating pain. The most common signs include:
- Painful periods (dysmenorrhea): severe cramping before and during menstruation
- Chronic pelvic pain: pain that persists beyond the menstrual cycle
- Pain during or after sex: deep pelvic pain during intercourse
- Pain with bowel movements or urination: especially during menstruation
- Heavy menstrual bleeding: periods that are heavier or last longer than usual
- Infertility: difficulty getting pregnant may be the first sign for some women
- Fatigue, bloating, nausea: symptoms that can be mistaken for other conditions
“If you’re experiencing any of these symptoms regularly, it’s important to talk to your doctor,” Dr. Ghomi advises. “Endometriosis is a real medical condition that requires attention.”
What Causes Endometriosis?
Although the exact cause of endometriosis remains unclear, researchers have identified several factors that may contribute to its development. Understanding these potential causes can help patients and doctors work together to manage the condition effectively. Contributing factors may include:
- Retrograde menstruation: This occurs when menstrual blood flows backward into the pelvis instead of exiting through the vagina. The displaced endometrial cells may attach to pelvic walls and organs, continuing to grow and bleed with each menstrual cycle.
- Genetics: Studies show that endometriosis tends to run in families. If a close relative has the condition, the risk of developing it increases.
- Immune system dysfunction: A weakened immune response may allow endometrial tissue to grow outside the uterus without being recognized and eliminated.
- Hormonal factors: Estrogen appears to promote the growth of endometriotic tissue, which is why hormonal therapies are often used to manage symptoms.
- Surgical procedures: Surgeries like C-sections or hysterectomies may accidentally relocate endometrial tissue outside the uterus, leading to endometriosis.
“While we don’t have a definitive cause, we do know that early detection and management can significantly improve a woman’s quality of life,” says Dr. Ghomi.
How Is Endometriosis Diagnosed?
Because some symptoms can mimic those of other conditions like irritable bowel syndrome (IBS) or pelvic inflammatory disease, diagnosing endometriosis can be challenging. A proper diagnosis often requires multiple steps, ensuring that other potential causes of pelvic pain are ruled out. Doctors use a combination of the following methods:
- Medical history and symptom review: A detailed discussion about symptoms, their duration, and how they impact daily life.
- Pelvic exam: During this exam, a doctor may feel for cysts, scar tissue, or tender areas that could indicate endometriosis.
- Imaging tests: Ultrasound or MRI can help identify cysts associated with endometriosis, known as endometriomas, but they may not detect smaller lesions.
- Laparoscopy: This is the gold standard for diagnosing endometriosis. A small incision is made in the abdomen, and a tiny camera (laparoscope) is inserted to examine pelvic organs. If endometriosis is found, the surgeon can remove or destroy the abnormal tissue during the same procedure.
“Laparoscopy not only confirms the diagnosis but also provides an immediate opportunity for treatment,” stresses Dr. Ghomi. “If we find endometriosis, we can remove the tissue to alleviate pain and improve outcomes.”
How Is Endometriosis Treated?
Endometriosis treatments depend on the severity of symptoms and a woman’s reproductive goals. While there is no cure for endometriosis, some patients find relief through medication. Others may require surgery to effectively manage the condition. These are the more common treatment options:
Non-Surgical Treatment Options:
- Pain management: Over-the-counter pain relievers, such as ibuprofen or naproxen, may help reduce inflammation and discomfort.
- Hormonal therapy: Birth control pills, patches, or hormonal IUDs can help regulate the menstrual cycle and slow the growth of endometrial tissue.
- Gonadotropin-releasing hormone (GnRH) therapy: These medications reduce estrogen levels and temporarily induce menopause to stop endometrial growth.
- Lifestyle Changes: Regular exercise, a balanced diet, and stress management techniques like yoga can help alleviate symptoms.
Minimally Invasive Surgical Treatment:
For women who do not respond to medication or have severe cases, endometriosis surgery may be the best option. Dr. Ghomi specializes in minimally invasive gynecologic surgery, which allows for precise removal of endometrial tissue with minimal recovery time.
“Surgery has advanced tremendously,” Dr. Ghomi explains. “With minimally invasive techniques, we can provide long-term relief with less pain, fewer complications, and faster recovery compared to traditional open surgery.”
- Laparoscopic excision surgery: Considered the most effective surgical treatment, this procedure involves removing endometriotic lesions with precision while preserving healthy tissue.
- Robotic-assisted surgery: Using advanced robotic technology, surgeons can perform highly precise procedures with minimal damage to surrounding tissues, leading to quicker recovery times.
- Hysterectomy (in severe cases): In cases of severe endometriosis that have not responded to other treatments, removing the uterus may be considered. However, this is usually a last-resort option.
“Each woman’s treatment plan should be tailored to her specific symptoms, goals, and reproductive plans,” encourages Dr. Ghomi. “If your symptoms are interfering with your daily life, don’t hesitate to seek help.”
When to See a Doctor
If you suspect you have endometriosis, it’s important to consult with a healthcare provider. Early diagnosis and treatment can prevent symptoms from worsening and improve overall well-being.
“You don’t have to suffer through painful periods or unexplained pelvic pain,” reassures Dr. Ghomi. “There are effective treatments available, and we’re here to help.”
Final Thoughts
Endometriosis is a challenging condition, but with the right treatment and support, women can lead full, active lives. If you or someone you know is experiencing symptoms, don’t wait. Reach out to a healthcare professional today.
For expert care and personalized treatment, schedule an appointment with Dr. Ali Ghomi.
