Most women expect some level of discomfort during their period. But when pain becomes intense, long-lasting or starts to interfere with everyday life, it could be a sign of something more serious — like endometriosis.
Endometriosis is a chronic, often painful condition that affects an estimated 10% to 15% of women of reproductive age — 190 million women worldwide. It occurs when tissue similar to the lining of the uterus, known as endometrial tissue, begins to grow outside the uterus. Most often, it’s found on the ovaries, fallopian tubes and pelvic lining, but can spread beyond that.
Dr. Elise Brown, a board-certified OBGYN at Sharp Grossmont Hospital, explains that, like the tissue lining the uterus, this tissue responds to hormonal changes during a menstrual cycle — thickening, breaking down, and bleeding each month. But because it’s outside the uterus, it has no way to exit the body, which can lead to inflammation, scarring and pain.
“Endometriosis is a complex condition that can cause significant pain and disrupt everyday life. But there are effective treatment options available to help you return to a more comfortable and fulfilling life,” she says.
Often a misunderstood condition, many myths and misconceptions surround endometriosis. We asked Dr. Brown to weigh in on four common endometriosis myths to provide greater understanding.
Myth: Endometriosis is just a “bad” period.
Fact: Endometriosis is more than just a painful period. While pain during menstruation is often the most common symptom, there are other physical and emotional challenges. Frequently, women experience discomfort during sex, urination or bowel movements. Others may deal with fatigue, nausea, and even anxiety or depression.
“The most accurate way to diagnose endometriosis is with laparoscopy or surgically,” says Dr. Brown.
Myth: There are no effective treatments for endometriosis.
Fact: While it’s true there’s currently no cure, endometriosis can be effectively managed through a variety of treatment options. Management strategies include medication, hormonal therapy, surgical intervention and fertility treatment, depending on individual symptoms and goals.
Pain management: Over-the-counter or prescription medications can help control pain.
Hormone therapies: Options such as birth control pills or GnRH (gonadotropin-releasing hormone) agonists help regulate or suppress estrogen levels, which help shrink endometrial tissue and relieve pain.
Surgical options: These options include both conservative and more extensive surgery.
Conservative: Aims to remove endometrial tissue while preserving the uterus and ovaries, making it a good option for those who wish to maintain their fertility. Laparoscopy is commonly used.
Hysterectomy and oophorectomy: Removal of the uterus (hysterectomy) or removal of the ovaries (oophorectomy) may be considered if other treatments are unsuccessful. While this may be the most definitive treatment, it is also considered to be a last resort when other treatment options haven’t worked. Removal of the ovaries causes premature menopause, which is helpful for endometriosis pain but can lead to increased risk of heart disease, thromboembolic disease and osteoporosis.
Fertility treatments: For those trying to conceive, options include ovulation-stimulating medications or assisted reproductive technologies like IVF (in vitro fertilization).
“Minimizing estrogen levels is central to reducing symptoms, and treatment should be personalized based on symptom severity, age, fertility goals and overall health,” says Dr. Brown.
Myth: Endometriosis causes infertility.
Fact: Endometriosis certainly makes it more difficult to become pregnant, but it doesn’t automatically mean infertility. About 30% to 40% of women with endometriosis struggle to conceive. However, depending on your diagnosis, many women are still able to become pregnant — either naturally or with medical support.
According to Dr. Brown, endometriosis affects fertility in several ways, including:
Scar tissue and adhesions may block the fallopian tubes.
Inflammation can affect the quality of eggs and sperm, potentially interfering with the implantation of a fertilized egg on the uterine wall.
Hormonal disruptions can impair ovulation and the implantation process.
In some instances, there are fewer eggs available for fertilization.
Myth: Endometriosis only impacts the pelvic area.
Fact: It’s true that endometriosis is commonly found in the pelvic region, including places outside of the uterus, like the ovaries, fallopian tubes and even the bladder. But endometriosis can occur anywhere in the body.
While it’s rare, endometrial-like tissue has been discovered in the lungs, diaphragm and even the brain. Understanding this dynamic helps break down the misconception that endometriosis is just bad period pain.
If you suspect you may have endometriosis or are dealing with ongoing pelvic pain or unusual symptoms, Dr. Brown says to talk with your health care provider. Early diagnosis and the right treatment plan can make a meaningful difference for your overall health.
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