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Endometriosis - Symptoms

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of endometriosis

Alternative Names

Hysterectomy and endometriosis

Symptoms:

Not all women with endometriosis experience symptoms. When symptoms occur, pain is the main one. Many women with endometriosis have chronic pain in the pelvic area (the lower part of the trunk of the body). The pain is often a severe cramping that occurs on both sides of the pelvis, radiating to the lower back and rectal area and even down the legs.

The severity of the pain varies widely and does not appear to be related to the extent of the endometriosis itself. In other words, a woman can have very small or few implants and have severe pain, while those with extensive endometriosis may have very few signs of the disorder except for infertility. Large cysts can rupture and cause very severe pain at any time.

Pain caused by endometriosis is associated with:

Menstruation. Women with endometriosis typically have heavy or prolonged menstrual bleeding, and very painful menstrual cramps (dysmenorrheal). Women may also experience pelvic pain at other times during their menstrual cycle and they may have spotting or bleeding between periods. Menstrual pain may worsen over time.
Sexual Intercourse. Endometriosis can cause pain during or after sexual intercourse (dyspareunia).
Urination and Bowel Movements. Pain during defecation or urination may be especially severe during menstrual periods. Women may also experience other gastrointestinal problems, such as diarrhea, constipation, or bloating.

Resources

www.asrm.com -- American Society for Reproductive Medicine
www.acog.org -- American College of Obstetricians and Gynecologists
www.endometriosisassn.org -- The Endometriosis Association
www.womenshealth.gov -- National Women's Health Information Center
www.endometriosis.org -- Endometriosis.org
www.resolve.org -- National Infertility Association

References

Bulun SE. Endometriosis. N Engl J Med. 2009 Jan 15;360(3):268-79.

Davis L, Kennedy SS, Moore J, Prentice A. Modern combined oral contraceptives for pain associated with endometriosis. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD001019.

Jacoby VL, Grady D, Sawaya GF. Oophorectomy as a risk factor for coronary heart disease. Am J Obstet Gynecol. 2009 Feb;200(2):140.e1-9. Epub 2008 Nov 18.

Johnson, N. and C. Farquhar. Endometriosis. Clin Evid. 2006;(15): 2449-64.

Lobo RA. Endometriosis. Etiology, pathology, diagnosis, management. Katz VL, Lobo RA, Lentz G, Gershenson D, eds. Comprehensive Gynecology. 5th ed. St. Louis, MO: Mosby; 2007: chap 19.

Mounsey AL, Wilgus A, Slawson DC. Diagnosis and management of endometriosis. Am Fam Physician. 2006 Aug 15;74(4):594-600.

Ortiz DD. Chronic pelvic pain in women. Am Fam Physician. 2008 Jun 1;77(11):1535-42.

Parker WH, Broder MS, Chang E, Feskanich D, Farquhar C, Liu Z, et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses' health study. Obstet Gynecol. 2009 May;113(5):1027-37.

Rodgers AK, Falcone T. Treatment strategies for endometriosis. Expert Opin Pharmacother. 2008 Feb;9(2):243-55.

Selak V, Farquhar C, Prentice A, Singla A. Danazol for pelvic pain associated with endometriosis. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD000068.

Shakiba K, Bena JF, McGill KM, Minger J, Falcone T. Surgical treatment of endometriosis: a 7-year follow-up on the requirement for further surgery. Obstet Gynecol. 2008 Jun;111(6):1285-92.

Reviewed last on: 8/5/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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