Endometriosis

Learn more about endometriosis and how it is treated.

Overview

Endometriosis is a condition in which the kind of tissue that normally grows inside the uterus grows in areas outside of the uterus. 

During a normal menstrual cycle, the endometrial tissue that lines your uterus thickens around the time of ovulation. You will then shed much of that tissue when you have a period.

However, if you have endometriosis, the endometrial tissue also grows outside of the uterus. It can grow on the ovaries, fallopian tubes, outside of the uterus and in other pelvic areas. The tissue will continue to thicken every month, but it cannot shed outside the body.

About 10 per cent of women experience endometriosis. It may run it families, but the cause is generally unknown. 

Our care

Learn more about the specialized care provided at Mount Sinai Hospital for Gynaecology.

This content is intended for informational purposes only and is not intended to be used or relied upon for any diagnostic or treatment purposes. It does not replace the need for consultation with a health-care professional. Please speak with your health-care professional for questions about your health.

Symptoms

Symptoms can vary and may depend on the location of your endometriosis. Symptoms may include any of the following:

Painful periods
Pain during sexual intercourse
Painful bowel movements
Painful or frequent urination
Infertility
Chronic pelvic pain

Diagnosis

There is no one test that can confirm an endometriosis diagnosis.

A gynaecologist is often able to provide a diagnosis based on your symptoms alone.

In some cases, medical imaging through ultrasounds or (less commonly) magnetic resonance imaging (MRI) can also be used to diagnosis endometriosis.

Treatment

Treatments for endometriosis focus on managing painful symptoms. There is currently no cure.

A gynaecologist will work with you to decide on a care plan that is specific to your needs. Note that hormonal therapy may not be suitable if you are trying to conceive.

Oral pain medication

Non-steroidal anti-inflammatory medications such as ibuprofen or naproxen can help reduce inflammation and decrease pain from endometriosis.

Progestin-only hormone therapy

Birth control medication that uses only progestin (such as IUDs, under-the-skin implants, birth control shots and pills) can help relieve symptoms by suppressing hormonal fluctuations.

Gonadotropin-releasing hormone (GnRH) agonists

This type of medication relieves symptoms by causing the ovaries to stop producing estrogen which induces a reversible, medical menopause.

Luteinizing hormone-releasing hormone (LhRH) agonists

LrRH agonists help relieve symptoms by suppressing the production of estrogen.

GnRH antagonists

This type of medication causes your ovaries to stop producing estrogen and progesterone which helps relieve symptoms of endometriosis.

Surgical management

Laparoscopic surgery to remove endometriosis tissue can relieve pain and may help patients who are trying to become pregnant. This is called excision of endometriosis.

This surgery can often provide long-lasting relief from symptoms. However, symptoms can return.

If other treatments do not work, or if adenomyosis is suspected, a hysterectomy to remove the uterus, in addition to the excision of endometriosis, can help relieve pain from endometriosis.

Hysterectomy should be carefully considered in patients younger than 35 to 40 years old, as they may enter menopause earlier even if they retain their ovaries.