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Navigating endometriosis: OB-GYN explains diagnosis and treatment

Endometriosis can cause pain, inflammation and scar tissue build-up, doctor says

Endometriosis affects about 190 million women and girls of a reproductive age worldwide.

While there is no known cure, early diagnosis and treatment can help to control symptoms.

Doctors recommend women should see their gynecologist once a year, as this is an important time to review your overall physical and mental health with your doctor, as well as to address specific concerns and to complete physical exams and tests.

Understanding endometriosis

Endometriosis is one of the more common and painful conditions women can discuss with their gynecologist.

“Endometriosis is a condition where (endometrial) tissue -- similar to the lining of the uterus -- grows outside the uterus,” said Dr. Ethan Goldstein, an obstetrician/gynecologist with the Detroit Medical Center. “This tissue can appear on the ovaries, the fallopian tubes, the intestines or other areas in the pelvis.”

During a woman’s menstrual cycle, the misplaced tissue responds similarly to the uterine lining, thickening and breaking down. However, it has no way to leave the body.

“This can cause pain, inflammation and scar tissue build-up,” Goldstein said.

The most common symptom of endometriosis is pelvic pain, especially around menstruation. The pain can be severe and debilitating.

Other symptoms can include:

  • Pain during sex.
  • Heavy or irregular periods.
  • Painful bowel movements or urination during menstruation.
  • Fatigue.
  • Difficulty getting pregnant.

It’s important to note that not every woman with endometriosis experiences all these symptoms, and the severity can vary greatly.

Goldstein said there is no single test for endometriosis, and the diagnosis often involves a combination of factors, including:

  • A woman’s medical history.
  • A pelvic exam.
  • Imaging tests like ultrasound or MRI.

Goldstein said sometimes a laparoscopy -- a minimally invasive surgery -- is needed to confirm the diagnosis and potentially remove or destroy the endometrial implants.

“If you suspect you might have endometriosis, it’s important to see a gynecologist to discuss your symptoms and get a proper diagnosis,” he said. “Early diagnosis and treatment can help manage the condition and improve your wellbeing.”

Treatment options

While there is not a cure for endometriosis, there are several treatment options the DMC provides to patients to help manage the symptoms and improve their quality of life.

These can include pain relievers, hormonal birth control pills, medications to suppress ovulation or surgery to remove endometrial implants and scar tissue.

“For endometriosis, surgery is used to remove as much of the diseased tissue as possible,” Goldstein said. “While it could be done laparoscopically, I use a minimally invasive approach, which is robotic-assisted surgery using the da Vinci robot. This technology allows for a much more thorough and detailed surgical diagnosis and treatment. This way I know I can provide my patients with excellent outcomes.”

The DMC is home to OB-GYN specialists who can provide specialized care and treatment for endometriosis.

Click or tap here to find a DMC gynecologist that’s right for you