LOS ANGELES, Calif. (FOX 11) - This Wellness Wednesday, we're talking about something that many women don't want to talk about.
Some celebrities have been getting the conversation started, like Lena Dunham. The actress recently revealed the lengths she had to go to to combat severe pain caused by endometriosis, which meant having a hysterectomy at 31-years-old.
Stars like Julianne Hough, Daisy Ridley, Padma Lakshmi and Whoopi Goldberg have also shared their stories.
To help us learn more about this all too common medical issue, Dr. Nita Landry joined us on Good Day LA to discuss what it is, the symptoms and more.
Known as "Dr. Nita," she's is a co-host on "The Doctors" and a board-certified OB/GYN.
What is endometriosis?
• Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body, like on the ovaries or fallopian tubes.
• This abnormal growth causes an inflammatory response, and there isn’t a known factor for how it gets there. Whether your case is considered mild, moderate, or severe depends on how widespread the growths are.
• It is generally acknowledged that an estimated 10% of all women during their reproductive years (from the onset of menstruation to menopause) are affected by endometriosis. This equates to 176 million women throughout the world and 1 in 10 women in the US.
• It often goes undiagnosed, especially if symptoms start early, because women write it off as bad period cramps.
Symptoms of Endometriosis
• Heavy periods
Many women with endometriosis experience extremely heavy periods and may even notice clots in their period blood. When you get your period, the endometrial growths react to menstrual hormones from your ovaries the same way the lining of your uterus does, so they grow and bleed, too. As endometrial growths get bigger over time, they can bleed even more.
• Abdominal pain, especially during your period
Pelvic pain is typically the most obvious symptom of endometriosis. Some people may have chronic pain that never goes away, but it usually gets particularly bad right before and during menstruation. When endometrial tissue bleeds in places where it can't (or can't easily) exit your body, it can cause swelling and pain, the U.S. Department of Health and Human Services explains. This cramping pain is usually most intense in the lower abdomen and lower back—like regular period cramps but way worse. In more moderate to severe cases, some women may develop blood-filled cysts, called endometriomas. If they rupture, they can be extremely painful and cause heavy bleeding.
• Gastrointestinal pain
Endometriosis can cause constipation, diarrhea, intestinal pain, and pain with bowel movements. These symptoms also look a lot like a gastrointestinal problem or a food intolerance, which is why endometriosis is often confused with IBS. Sometimes IBS can accompany endometriosis, which can make a diagnosis that much more complicated. While good bowel health could have a positive effect on some types of endometriosis pain, it's not going to make it disappear.
• Painful intercourse
Painful sex is another big indicator of endometriosis. The pain can happen during sex, right after, or even continue into the day after. Pain with orgasm is common, but people don’t usually articulate it. Sex can be even more painful before or during your period, when the tissue becomes most inflamed.
Up to 50 percent of women with endometriosis experience infertility. It's actually possible that the only symptom of the disease you have is infertility. For many women, they don't learn that they have endometriosis until they start having trouble getting pregnant and go in for a full fertility workup.
• The only true way to diagnose endometriosis is a procedure called laparoscopy, where you're put under anesthesia and a small incision is made and the tissue is actually examined.) Depending on how severe your case is, removing the endometrial tissue completely can increase your chances of conceiving and carrying a pregnancy to term. Take your health into your own hands, and ask your doctor about endometriosis if you think you're suffering from it.
• Pain medications -Your doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps.
• Hormone therapy - Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue. Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.
• Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives — especially continuous cycle regimens — may reduce or eliminate the pain of mild to moderate endometriosis.
• Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication.
• Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.
• Conservative surgery
If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery — however, endometriosis and pain may return. Your doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases. In laparoscopic surgery, your surgeon inserts a slender viewing instrument (laparoscope) through a small incision near your navel and inserts instruments to remove endometrial tissue through another small incision.
In severe cases of endometriosis, surgery to remove the uterus and cervix (total hysterectomy) as well as both ovaries may be the best treatment. A hysterectomy alone is not effective — the estrogen your ovaries produce can stimulate any remaining endometriosis and cause pain to persist. A hysterectomy is typically considered a last resort, especially for women still in their reproductive years.
Watch the full video above!