Dealing with Painful Endometriosis

It’s a common women’s health issue. So, it’s not surprising that one of the women at the Women’s Health Panel in Florence ask about endometriosis. McLeod Gynecologist Eric Coughlin, MD, offered this explanation to the 100 people present.

Here’s an overview of Dr. Coughlin’s comments:

What is endometriosis? The lining of the uterus is made up of endometrial glands. Any time that those endometrial glands – the tissue you would shed in your period — grow anywhere else, is it endometriosis. It can be inside of your body but they can be found, essentially, anywhere. Even in the lung or nose. But these are very rare.

Most commonly, it’s on the surface of the uterus or somewhere around in the pelvis. When that happens, there’s a constellation of symptoms patients may have. The main symptoms we see are painful periods, heavy bleeding, pain with intercourse or general abdominal pain or discomfort more than what would be expected with your normal periods.

Even with that, some women don’t experience severe pain. A woman might have the worst endometriosis — based on an exam, symptoms or discovered surgically — but experience no pain. Yet, someone with the worst pain may have very few internal endometrial implants.

As far as treatment, there is a wide variety of things that can be done. We can start with just watching and waiting, which probably would not be the best case. Better treatments include medical management with oral medicines, such as birth control or injectable medicines like Lupron or a new medication that on the market, called Orilissa, which is similar to Lupron.

Surgery can be used to remove the endometrial implants. Sometimes a woman can form growths called endometriomas, which definitely cause significant pain. Ultimately, some women do require surgery to manage that pain. Yet, we have a large spectrum of possible treatments based on what we find during the examination. Not everyone presents the exact same way and not everyone is treated the exact same way.

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