photo: Marissa Pina, Vivala
If you don’t have endometriosis, a painful condition in which the cells of the endometrial lining (the womb) grow outside of the uterus, chances are you know a person or two who does. That’s because endometriosis is a lot more common than people realize. In fact, endometriosis affects an estimated one in 10 women during their reproductive years. And yet so many of us still don’t know enough about it. We spoke to a few experts who broke down everything you need to know about this common pelvic condition. 

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1. What are the common symptoms? “The most common symptoms are bad menstrual cramps, heavy menstrual bleeding, and periods that last longer than seven days,” says Dr. Deanna Berman, a Vermont-licensed naturopathic doctor and New York State-certified midwife. “More severe symptoms can include painful intercourse, bowel, and bladder issues, including symptoms of irritable bowel syndrome (IBS) or infertility.” If you’re noticing any of these symptoms especially during your pre-menstrual or menstrual cycle, you should consult with your doctor. 

2. What causes it? The problem with endometriosis is that the cause for it is still unknown. “The incidence and prevalence of endometriosis are difficult to determine, because the diagnosis is a surgical one,” says board-certified gynecologist, Dr. Carolyn C. Thompson. “There are likely women with endometriosis who are asymptomatic and therefore not diagnosed, because they never have surgery.” In order to diagnose it, doctors perform a diagnostic laparoscopy, where they examine the pelvic organs looking for endometriosis lesions, endometriosis-filled cysts, adhesions, and scarring. 

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3. How do you treat it? There are various treatments for endometriosis, such as anti-inflammatory drugs and hormonal contraceptives including the pill, DepoProvera, Nuvaring, and Nexplanon, which help with symptoms like pelvic pain or heavy menstrual bleeding. Lupron is another drug that’s commonly used to treat endometriosis. 

4. What if none of those drugs work? If all else fails, consider surgery, suggests Dr. Joshua M. Hurwitz, a board-certified reproductive endocrinologist and partner at Reproductive Medicine Associates at Connecticut (RMACT). “Laparoscopy can be performed to not only diagnose endometriosis, but also to cauterize it and destroy any endometriosis tissue.” 

5. Can it come back? Yes, even if you undergo surgery. Berman recommends seeing a naturopathic doctor if you do decide to have the surgery, because he or she can help address underlying causes and put you on nutritional supplements that can help prevent the recurrence of new lesions.

6. Can if affect fertility? “Endometriosis can lead to infertility by scarring the fallopian tubes so that fertilization (which happens in the tubes) cannot take place,” says Dr. Thompson.

However, Hurwitz stresses that the surgery can also potentially impact your fertility, so if you know you want to have children at some point, definitely talk to your doctor about all your treamtent options before going under the knife. This way, you can be sure you're making the best choice for your health and lifestyle.