Page 20 - Dr Pamela Peeke

Endometriosis: Act Early

By Jamie Lober

As a woman, building an honest relationship with your gyne- over time. In other cases, endometriosis is asymptomatic:
cologist can be good for your health - even lifesaving. If you Ironically, the symptoms do not always equate to the degree
experience extreme discomfort at the onset of your period, of the disease. “People with the worst endometriosis can
or any time during your cycle, you should talk about it during have the fewest symptoms,” informs Dr. Rovena Reagan of
your visit. It may just be a painful period, but it can also be Women’s Health Care. Do not jump to conclusions without
endometriosis. “Endometriosis is a benign condition. It is an consulting with your gynecologist.
inflammation but is not caused by infection. It could be mild,
moderate or severe depending upon which part of the repro- If you think you may have endometriosis, you are not alone.
ductive organ is affected,” explains Dr. Joshua Cohen. “There appear to be about eight million with endometriosis
in the United States and many of them go for up to ten years
Symptoms of endometriosis in a menstruating woman may before they get an accurate diagnosis,” tells Dr. Christopher
include cramping, bloating, fatigue, nausea, abdominal, O’Brien, chief medical officer of Neurocrine Biosciences.
lower back or vaginal pain or pain during intercourse. This Other times, women may have trouble becoming pregnant
discomfort can occur at any time during the cycle. It is im- and then be diagnosed with endometriosis by a fertility spe-
portant to be proactive because endometriosis can worsen cialist.

The etiology (or cause) is controversial. It
can be explained by retrograde menstrua-
tion; menstrual flow entering the fallopian
tubes, abdominal cavity or pelvic area.
However, there are other theories. “When
the woman is at the early fetal age and the
pelvic structure started to be designed by
nature, some of the endometrial glands get
abnormally implanted outside of the uter-
20 ine lining and fall anywhere outside of the
uterus, around the ovaries or pelvic side
walls or even further distance especially
the bowel, bladder or diaphragm,” Cohen
informs. Others believe it is genetic. “It is
slightly more common running in families,”
says O’Brien. There are several options for
relief.

Treatment is individualized. “Women
should tailor it based on symptoms. If you
are doing fine taking Motrin or Aleve, then
you are probably fine. When it gets to the
point that it is interfering with daily function
or ability to have sex, it should be treated,”
Reagan advises. Birth control pills are
usually the next step. “There are other
more powerful drugs which completely
shut down your system and put you into
menopause, have more side effects and
are more costly,” Reagan says. Lupron is
one example. “There are vaginal rings to
treat endometriosis and an old treatment
that is coming back into favor is the drug
Danazol,” Reagan adds. You are sure to
find an option that will help manage your
symptoms.

Issue 2, 2009