Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside of it, most often on the ovaries, fallopian tubes, and the tissue lining the pelvis. That tissue responds to your monthly hormone changes the same way your uterine lining does. It thickens and bleeds, but it has no way to leave your body, which leads to inflammation, scar tissue, and pain. The World Health Organization estimates it affects roughly 10% of women and girls of reproductive age.
It is common, it is treatable, and yet for many, it is still diagnosed far too late.
The Symptoms Go Well Beyond Painful Periods
Severe menstrual cramps are the symptom most people associate with endometriosis, but they are not the only symptom, and some patients never have unusually painful periods at all.
Other signs worth mentioning to your provider include pelvic pain between periods, pain during or after sex, painful bowel movements or urination that worsens around your period, heavy or irregular bleeding, and persistent fatigue. Digestive symptoms like bloating, constipation, and diarrhea are common enough that endometriosis is sometimes mistaken for irritable bowel syndrome for years. Difficulty getting pregnant is sometimes the first symptom that brings a patient in.
The amount of pain does not predict how much disease is present. Some patients with extensive endometriosis have mild symptoms, and some with small areas of tissue have severe pain.
Why Diagnosis Is Often Delayed
Research has consistently found a gap of several years between when endometriosis symptoms start and when a diagnosis is made. A few reasons drive that delay.
- Painful periods are normalized. Many patients are told from adolescence that bad cramps are simply part of having a period, so they never raise it.
- The symptoms overlap with other conditions, including IBS, interstitial cystitis, ovarian cysts, and pelvic inflammatory disease.
- Endometriosis does not show up reliably on standard imaging. A normal ultrasound does not rule it out.
If pain is causing you to miss work or school, or if over-the-counter pain medication is not touching it, that is not something you should deal with on your own.
How Endometriosis Is Diagnosed Today
Diagnosis starts with a detailed history of your symptoms and their timing, followed by a pelvic exam. Ultrasound is used to look for endometriomas, which are cysts on the ovaries, and to rule out other causes of pelvic pain. MRI is sometimes ordered when deeper disease is suspected.
Laparoscopy, a minimally invasive surgery that allows a surgeon to see and biopsy endometriosis directly, remains the only way to confirm the diagnosis definitively. Importantly, American College of Obstetricians and Gynecologists guidance no longer requires surgery before treatment begins. Providers can diagnose endometriosis clinically and start treatment based on symptoms, which spares many patients an unnecessary delay.
Treatment Options
Treatment is chosen around your symptoms, your age, and whether you want to become pregnant now or later.
Medical management is usually the starting point. NSAIDs such as ibuprofen help with pain, particularly when started before cramping peaks. Hormonal therapies work by suppressing the monthly cycle that feeds the tissue, and they include combined birth control pills, the progestin-only pill, hormonal IUDs, and the Nexplanon implant. When those are not enough, gonadotropin-releasing hormone (GnRH) medications may be considered. It can take a few cycles to know whether a given option is working, so patience with the process helps.
When pain persists despite medication, or when an endometrioma or scar tissue is affecting fertility, surgery becomes the next step. Our practice performs minimally invasive gynecological surgery, including laparoscopy, to remove endometriosis tissue and adhesions. These techniques typically mean smaller incisions and a faster recovery than open surgery.
If You Are Trying To Conceive
Endometriosis is one of the leading causes of infertility, but many patients with the condition conceive without assistance. If you have been trying for a year without success, or six months if you are over 35, bring it up sooner rather than later. Surgical removal of endometriosis can improve the odds of natural conception in some cases, and fertility considerations should shape which treatment you start with, since hormonal therapies prevent pregnancy while you are on them.
Living Well While You Manage Endometriosis
Alongside medical treatment, pelvic floor physical therapy helps many patients whose muscles have tightened in response to chronic pain. Heat, regular exercise, and sleep support pain control. Chronic pain also takes a real mental health toll, and that is worth addressing directly rather than dealing with it alone.
Get Answers About Your Pelvic Pain in North Las Vegas
You should not have to plan your life around your period. The team at Dr. Nader and Associates has been caring for women in the Las Vegas community since 1996, and we offer full evaluation and treatment for endometriosis, including medical management and minimally invasive surgery. We accept Medicaid and most major insurance plans, and free transportation is available for Medicaid patients at 844-879-7341.
To schedule an appointment at Dr. Nader and Associates, call (702) 818-1919 or book online through Healow.
