Questions about Endometriosis

What is endometriosis?

The endometrium is the tissue that lines the uterus. Endometriosis is the presence of endometrial tissue in places where it is not normally found. Common sites of involvement are the ovaries, space behind the uterus (cul-de-sac, rectum, uterosacral ligaments) and urinary bladder. Endometriosis is usually confined to the pelvis.

What causes endometriosis?

Research has shown that many women with endometriosis appear to have a defect in their immune system. Other causative factors may be: spillage of menstrual blood into the pelvis through open fallopian tubes; movement of endometrial cells throughout the pelvis (and even outside of the pelvis) through blood and lymphatic systems; and the ability of certain cells to change into endometrial cells, hence endometriosis.

Does endometriosis cause infertility?

Endometriosis has been identified as a major cause of infertility. However, having endometriosis does not mean that a woman will have trouble conceiving. Some women with endometriosis conceive without trouble.

Will any medical or surgical treatment cure endometriosis?

There is no known cure for endometriosis. Hormonal and other medical treatments can be useful in most situations, such as controlling pain, but as with surgical therapies, it does not eradicate the disease. In general, endometriosis is managed most effectively with a combination of properly performed surgery and the use of appropriate medical therapies.

I have been diagnosed as having endometriosis. Do I have a greater chance of developing ovarian cancer?

No. Endometriosis is not thought to be associated with increased risk of ovarian cancer.

I have been diagnosed as having advanced endometriosis. Will I need hysterectomy?

Usually not. A maximal surgical effort in conjunction with medical and other treatments will often prevent the need for hysterectomy. Whereas the disease may not be curable, it is usually controllable.

I am 32 years old and have been trying to conceive for two years. I have been diagnosed as having advanced endometriosis. I have never been pregnant, and my partner's sperm count is excellent. Should I be optimistic that I will conceive?

Absolutely! Studies have shown that properly performed surgery can improve the chance of pregnancy in women with endometriosis.

I have advanced pelvic endometriosis and severe pelvic pain. What chance do I have of pain relief after resection of endometriosis?

Approximately 50% of patients experience major pain relief, a further 30% have adequate improvement and the final 20% are not improved. Often the latter group has additional problems.

What about holistic treatments?

Diet, massage therapy, acupuncture and other holistic approaches have been used in endometriosis patients with varying degrees of success.