It's a problem that affects about one in 10 women around the world, but it doesn't get talked about as much as it should. Until now. Singer Halsey and Lena Dunham have both gone public about their struggle with endometriosis — and while their high-profile admissions will help bring awareness to the painful disease, it's still something that's woefully misunderstood.
?Endometriosis occurs when tissue lining the uterus (endometrial tissue) grows outside the uterus, in areas such as the ovaries, fallopian tubes, bladder, or intestines, according to Isabelle Ryan MD, with Pacific Fertility Center in San Francisco.
"Although its cause isn’t clear, some researchers think endometriosis happens after endometrial tissue from menstrual flow travels backwards through the fallopian tubes and out into the pelvic cavity and becomes fixed to the area," Dr. Ryan tells SheKnows. "This eventually causes inflammation, pain and scarring of the fallopian tubes, ovaries and surrounding reproductive anatomy."
It's often misunderstood, especially when it comes to diagnosis and treatment, according to Dr. Ryan. Here's what you need to understand about the disease if you think you might have it.
Symptoms can be a number of things
The symptoms of endometriosis can range from mild to severe, but can include period pain, pain during sex, fatigue, urination and bowel pain, diarrhea, constipation and nausea.
Fertility can also be affected with endometriosis. "A diagnosis of even minimal to mild endometriosis (stage I and II) can have significant consequences on fertility success rates," says Dr. Ryan.
True diagnosis comes from surgery
Your doctor can make an initial diagnosis by understanding the frequency and severity of your symptoms, but confirmation comes from a surgical procedure called a laparoscopy, which uses a thin, lighted tube (laparoscope) placed through a small incision in the belly button to examine the pelvic area.
"At this time, a sample of tissue is removed and examined under a microscope," says Dr. Ryan.
It's treated a variety of ways... or not at all
Treatment doesn't cure the condition, but it may help relieve symptoms and improve pregnancy outcomes. If symptoms aren't a problem, you may not need treatment at all, according to Dr. Ryan. Pain relievers like ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve) or anti-inflammatory drugs (NSAIDs) can be taken to manage pain, but if it's severe, surgery might be the best option.
"The surgeon may surgically treat the condition by removing as much visible growing tissue as possible," adds Dr. Ryan.
It can affect fertility
Endometriosis can be less thick (superficial) or deeply invasive and may impair fertility in one or more ways.
For getting pregnant, in most cases of more severe and extensive endometriosis, many doctors will advocate for in vitro fertilization to help get the eggs, sperm and embryos out of the pelvic environment, which has been shown to be toxic to these cells.
"Your chances of getting pregnant depend mainly upon the severity of the disease — its amount, location, and depth — ranked from mild (Stage 1), which has a better chance of success, to severe (Stage 4), which has a low chance of success," says Dr. Ryan.