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Endometriosis, a condition that affects an estimated 176 million women worldwide, can cause severe pelvic pain, especially during your menstrual cycle. Left untreated, endometriosis can cause problems with fertility. The good news is that there are treatments that can help if you have endometriosis, so find an SSM Health provider who can help you explore your options.

The endometrium is the inner lining of the uterus. This tissue builds up every month to prepare for pregnancy and is shed during your period if pregnancy doesn't occur. Endometriosis occurs when this tissue grows outside of your uterus. Endometriosis lesions can be found anywhere in the pelvic cavity - on or in the ovaries, on the fallopian tubes or on the pelvic sidewall. They can also be found on the bowel and bladder. This condition, which can lead to chronic pelvic pain and infertility, is found in 15-80% of women with chronic pelvic pain and in 21-65% of women investigated for infertility.

Signs & Symptoms of Endometriosis

The main symptoms of endometriosis are pelvic pain, adhesions and infertility.

For many women, the pain of endometriosis is debilitating and affects their lives in significant ways. For others, the pain of endometriosis is milder. Pain from endometriosis often occurs with the menstrual period, but a woman with endometriosis may also experience pain at other times, such as with intercourse and bowel movements.

In addition to pain, endometriosis may cause:

  • Diarrhea
  • Constipation
  • Abdominal bloating
  • Irregular or excessive bleeding
  • Fatigue

Endometriosis can also cause scar tissue and adhesions to develop, distorting a woman's internal anatomy. In advanced stages, this can be severe, and internal organs such as the uterus, ovaries and bowel may be become attached to each other.

Make an appointment today to see your doctor if you are experiencing any signs and symptoms of endometriosis. They may choose to schedule diagnostic testing to get to the root of your problem.

Endometriosis Treatment

Endometriosis treatment includes pain medications, hormone suppression or surgery. Pain medications and hormone suppression treat the symptoms of endometriosis, but surgery is the only treatment that can potentially cure the disease and restore normal anatomy.

Surgical Options

At the SLUCare Center for Endometriosis at SSM Health St. Mary's Hospital, the goal of surgery is the complete removal of all visible endometriosis. This approach has been shown to have the potential to eradicate the disease and prevent progression when performed by an experienced surgeon. Surgery to treat endometriosis is performed through a minimally invasive technique called laparoscopy, which leads to less postoperative pain, faster recovery and better cosmetic results.

The following video explains what happens during surgical treatment of endometriosis:

Our physicians perform "see and treat" laparoscopy, which allows us to diagnosis and treat endometriosis during the same procedure, when possible. After surgery, various techniques are used to prevent postoperative adhesions or scarring, which can cause pain and negatively affect your fertility.

While removal is not proven to be superior to ablation techniques, removal of areas thought to have endometriosis has a number of advantages:

  • The lesion is excised down to normal tissue ensuring its complete removal
  • Fewer areas are produced that can lead to adhesions
  • The material removed is sent to pathology for a definitive diagnosis

Making the decision to have surgery can be a difficult one. Don’t hesitate to request a second opinion if you’re unsure if this is the right  choice for you.

Clinical Trials

The SSM Health Center for Endometriosis is at the forefront of ongoing research to improve how endometriosis is treated. Recently published studies have shown the potential of complete excision in experienced hands (even without postoperative long term hormone suppression) to eliminate disease even in teenagers, a traditionally very difficult population to treat for endometriosis. Ongoing landmark trials are also being performed to further evaluate the value and curative potential of removal in the treatment of endometriosis. Such research benefits patients by offering them access to the most cutting edge technology and treatments.

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