Endometriosis is a painful disease that affects 1 in 10 women, but it can
be tough to diagnose because it shares symptoms with so many other conditions.
What happens is the tissue that normally lines the
inside of a woman’s uterus grows
outside the uterus. But, it doesn’t break down and shed like it would inside
the uterus. Instead, the trapped tissue can trigger inflammation, sometimes
intense pain, and a host of other issues.
There is no single cause for endometriosis, but here are some risk factors
to keep in mind: infertility, shortened cycles, elevated estrogen levels,
smoking, starting menstruation earlier or experiencing menopause later.
If a close family member has endometriosis, you are at an even higher risk.
What are the Symptoms of Endometriosis?
Symptoms typically begin during puberty and most often parallel menstrual
periods. But, pain and cramping can begin before and last several days
after a period. The most common symptoms include:
- Painful periods
- Pain with urination or bowel movements
- Excessive bleeding
- Pain during or after sex
- Gastrointestinal issues like diarrhea, constipation or nausea
The Diagnosis Dilemma
There is an average 10-year delay from the onset of symptoms to the diagnosis
of endometriosis, according to the Endometriosis Foundation of America.
The lag in proper diagnosis is partly due to misinformation about endometriosis
but more so because the symptoms are similar to other gynecologic and
gastrointestinal issues. Here are the top conditions that endometriosis
is mistaken for:
Dysmenorrhea: This is the medical term for menstrual cramps. Primary dysmenorrhea refers
to common cramps that may include other symptoms like nausea, vomiting
and fatigue, while secondary dysmenorrhea is caused by a disorder in the
Adenomyosis or Uterine Fibroids: Adenomyosis occurs when endometrial tissue moves into the outer muscle
walls of the uterus, resulting in a mass of cells that can cause painful
cramping, heavy bleeding, bloating and infertility. Because the symptoms
are so similar, adenomyosis is often misdiagnosed as uterine fibroids,
which are benign tumors growing in or on the uterine wall. An ultrasound
can rule out fibroids, making endometriosis the likely culprit. Adenomyosis
is harder to diagnose – imaging is an option but often surgery is
Ovarian cysts: These are common and often go away on their own, but if the cysts get
too large or rupture, they can cause a lot of pain. Certain cysts can
mimic endometriosis on an ultrasound.
Pelvic adhesions: Scarring from an infection of previous surgery is often misdiagnosed
as endometriosis. The pain from these adhesion is not as tied to a woman’s
cycle, which is a big clue that it’s
What to do?
If you or your daughter feel like something is not right, listen to your
body but don’t try to figure it out alone. An OB/GYN will take the
time to listen to your concerns – and those painful symptoms –
and get to the bottom of what’s really at play. The good news is
that effective treatments are out there, but an accurate diagnosis is
key in choosing the right one.
Dr. John Wise, OB/GYN
Baton Rouge General Physicians
Phone: (225) 237-1880
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