Talking With Your Doctor About Endometriosis
Endometriosis—when the tissue that lines the uterus grows in areas outside the uterus—is a common problem in women. It can cause severe cramping and pain, especially during your period. Having endometriosis can also make it hard to get pregnant. If you think you may have endometriosis, your doctor can help. Here are topics to bring up with your doctor that will help him or her decide the best course of treatment—for you.
In most cases, your doctor will ask you about your symptoms and do a pelvic exam to check for signs of endometriosis. Try to describe your symptoms in detail and consider keeping a symptom diary. You can record information about your symptoms and your periods to share with your doctor.
If your doctor thinks you have endometriosis, you will likely need to have a laparoscopy. This is a surgical procedure to look inside your abdomen. To do this, your doctor will make a small cut in your skin and use thin tubes and a small camera to look for growths. Having a laparoscopy is the only way to tell for certain whether you have endometriosis.
After doing a laparoscopy, your doctor should be able to tell you how widespread your endometriosis is, and where it’s located. Your doctor may rate your condition by telling you the stage of your endometriosis:
- Stage 1 is minimal endometriosis.
- Stage 2 is mild endometriosis.
- Stage 3 is moderate endometriosis.
- Stage 4 is severe endometriosis.
Your doctor may use this information to come up with a treatment plan for you.
There are many treatments for endometriosis. Not every treatment works for all women. Your doctor can help you find the right treatment for you based on your symptoms, your age, and your plans for having children. Options to discuss include:
- Pain medicines. If your symptoms are mild, over-the-counter pain medicines, such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin), may work well. For stronger pain relief, your doctor may prescribe other pain medicines.
- Birth control pills. The hormones in birth control pills can help prevent endometrial tissue from growing too much. This can help control symptoms.
- Hormone treatment. Your doctor may also talk with you about other types of hormone treatments. These include GnRH agonists and antagonists, progestins, and danazol (Danocrine). These hormones stop or reduce your menstrual cycles, which can help reduce symptoms. Each of these hormones can also cause side effects, including weight gain, depression, and vaginal dryness.
- Laparoscopic surgery or laparotomy. During surgery, your doctor can remove the endometrial tissue that has grown outside the uterus. Your doctor may suggest this surgery if you have severe symptoms. In some cases, surgery may also help improve your chances of getting pregnant.
- Hysterectomy. This is a type of surgery to remove your entire uterus. In some cases, your ovaries may also be removed. Your doctor may suggest this type of treatment if no other treatments have worked. You cannot get pregnant after this surgery. Talk with your doctor about any future plans for having children before deciding on a hysterectomy.
Having endometriosis can make it harder to get pregnant, but this is not true for all women. You may find that you have no trouble getting pregnant or that it just takes a little longer. In some cases, you may need surgery or fertility treatments. If you want to get pregnant, talk with your doctor about your options. It’s important to stop taking certain medicines for endometriosis before getting pregnant. In most cases, symptoms stop during your pregnancy.
There is no cure for endometriosis. But many women find the treatments help relieve or stop symptoms. In many cases, endometriosis goes away after menopause, when you stop having periods.