​​​​I love walking around the radio station and chatting with friends. Recently, I told my coworker, Julie, that I was headed to The Christ Hospital to do an interview about endometriosis. She said, “Well, what do you need to know about it? I have endometriosis.” I was a little shocked because she told me about a few other coworkers who also have endometriosis. I don’t think I realized just how common it was and how many people I know personally who are affected. March is Endometriosis Awareness Month—and the reason I reached out Dr. Jacqlyn Riemersma, an OBGYN with The Christ Hospital Health Network, to find out more.

What is endometriosis?

Dr. Riemersma told me that endometriosis is a chronic, benign, inflammatory disease where cells like those normally found in the endometrium (the name for the inner lining of the uterus) are found outside the uterine cavity.

According to Dr. Riemersma, there are many different theories on what causes endometriosis. “It is likely that the cause is multifactorial with several mechanisms contributing” she said. “The most common theory is that menstrual blood and endometrium flows backward from the uterus through the fallopian tubes and into the pelvis. This tissue then implants and grows where it lands, resulting in an inflammatory response.”

Diagnosis

When it comes to being diagnosed with endometriosis, you must pay attention to the symptoms and listen to your body. Dr. Riemersma said, “Endometriosis may be suspected based on your symptoms, which might include pelvic pain (before, during, or between your periods), pain during or after sex, pain with bowel movements or while urinating, or difficulty getting pregnant. You may also have a specific type of ovarian cyst that can occur in endometriosis called an endometrioma. The only way to know for sure if you have endometriosis is to undergo surgery and a biopsy of the abnormal tissue, but this isn’t required, and we can treat based on a suspected diagnosis.”

Treatment

Treatment for endometriosis can differ from person to person. Dr. Riemersma says, “Treatments for endometriosis are aimed at either treating the pain associated with it or in addressing infertility concerns. The goal is to maximize the use of medical treatment and avoid repeated surgical procedures. Medications cannot get rid of endometriosis, but they often help achieve the goal of treating the pain.

“One of the treatment options is NSAIDs (non-steroidal anti-inflammatory drugs), like ibuprofen or naproxen, to decrease the release of prostaglandins and reduce inflammation. This is more effective if you start it 1-2 days before your period. Hormonal birth control can help treat pain because they can reduce or prevent menstrual bleeding. Finally, gonadotropin-releasing hormone agonists or antagonists can cause the ovaries to temporarily stop producing estrogen, which can cause endometriosis tissue to shrink.”

Is surgery an option?

Dr Riemersma went on to say, “Surgery can be considered in women with persistent pain despite medical therapy, inability to use any of the medication options, need for a tissue sample for diagnosis, or for more advanced disease with bowel or bladder complications. Surgery can potentially treat endometriosis by allowing us to remove or destroy endometriosis tissue or break up scar tissue; however, this is not a permanent cure. Surgery may also be recommended if you have a specific type of ovarian cyst called an endometrioma. In women who do not get relief from medications or removing or destroying endometriosis tissue, a hysterectomy may be an option.”

Getting pregnant with endometriosis

Women with endometriosis could have difficulty getting pregnant and should talk to their doctor about trying to get pregnant. Dr Riemersma said you can get pregnant, but, “Women with endometriosis do have higher rates of infertility (30-50% higher than women without). If you have endometriosis and are having difficulties getting pregnant, you should see your doctor, as infertility often has multiple causes. We would recommend a workup because endometriosis (even if you have it) should not be assumed to be the cause. You may need surgery to remove ovarian cysts related to endometriosis or assistance getting pregnant with medications.”

If you would like to learn more about Dr. Riemersma, click here​.