Doctor's Notes on Endometriosis
Endometriosis is a common disorder in women in which tissue similar to the lining of the uterus (endometrium) develops in other areas of the body, typically within the pelvic area or the abdominal cavity. In rare cases, endometriosis occurs outside the abdominal cavity, such as in the brain or lungs. It may also develop in surgical scars following surgery on pelvic organs. Endometriosis is the leading cause of chronic pelvic pain in women. Endometriosis can also cause infertility.
Symptoms of endometriosis can vary in intensity and may include
- pelvic pain that is worse just before menstruation and improves at the end of the menstrual period,
- pain during menstruation (dysmenorrhea), and
- infertility.
The pain is often described as a constant, aching pain that is deep and often spreads to both sides of the pelvic region, the lower back, abdomen, and buttocks.
Endometriosis symptoms usually go away when a woman goes through menopause.
What Are the Treatments for Endometriosis?
Endometriosis is treated with medications and surgery. Medications are to treat endometriosis symptoms and the overgrowth of abnormal tissue.
Medications used to treat endometriosis include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain
- Hormonal birth control
- Pills, patches, and vaginal rings to reduce or prevent menstrual bleeding
- Intrauterine device (IUD) containing progestin to help treat pain
- Aromatase inhibitors
- Gonadotropin-releasing hormone (GnRH) analogs and GnRH antagonists
- Nafarelin (Synarel)
- Leuprolide (Lupron)
- Elagolix (Orilissa)
Surgical treatments for endometriosis can be both diagnostic and therapeutic. These surgical treatments include:
- Endometriosis surgery is often done laparoscopically, and the goal is to remove endometriosis and scar tissue
- A laparoscopy can be used initially to confirm the diagnosis of endometriosis
- It is not a permanent cure and endometriosis tissue frequently grows back and pain returns without post-surgical treatment such as hormonal birth control
- Surgery for endometrioma (ovarian cysts containing endometriosis tissue) is usually only done if the cyst is larger than 4 to 5 cm, symptomatic, or growing
- A full hysterectomy with removal of the uterus, ovaries and fallopian tubes is the only potential cure for endometriosis in patients who:
- Do not wish to become pregnant in the future
- Want a permanent treatment
- Have tried and failed medical management
Endometriosis : Test Your Medical IQ Quiz

Endometriosis occurs deep inside the uterus.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.