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Endometriosis, an often painful disorder of the female reproductive system, is most common in women in their 30s and 40s. For many women, a diagnosis of endometriosis can often be confusing or worrisome — and for good reason.

What is endometriosis?

With endometriosis, tissue that normally lines the uterus grows elsewhere in the body. It’s most commonly found in the abdomen, but in rare cases, endometrial cells are found in organs far from the pelvis. Endometriosis can cause pelvic pain, especially during menstruation and intercourse, though many women have no symptoms at all. It has been linked to infertility, making early detection and treatment important for Dallas women.


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Symptoms of Endometriosis

Symptoms of endometriosis most often involve pelvic pain, which can worsen during intercourse and periods.

Painful Periods

The most common symptom of endometriosis is pelvic pain, typically associated with periods. While some level of pain is a usual occurrence for most during their periods, those with endometriosis often describe menstrual pain that’s far worse than usual, and may also begin before the period and extend several days into it. Lower back and abdominal pain may increase as well.

Pain with intercourse

Unusual pain during or after intercourse is another common sign of endometriosis.

Pain with bowel movements or urination

Noticeable levels of unusual pain when using the bathroom is one the more common symptoms of endometriosis.

Excessive bleeding

Those with endometriosis often experience heavy bleeding during periods and may even have bleeding between periods.


Women who are having problems with fertility alongside some of the above symptoms may have endometriosis — which may be the possible cause of the infertility in the first place.

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The Causes of Endometriosis

The exact cause of endometriosis is unknown. Some women experience retrograde menstruation in which menstrual blood flows out of the fallopian tubes into the abdominal cavity. It’s possible that endometrial cells escape into the bloodstream and colonize other areas of the body, or that endometrial cells are transferred from the uterus to other parts of the body during abdominal surgery. Immune system disorders may also be a possible cause of endometriosis.

The Diagnosis of Endometriosis

In order to diagnose endometriosis, your doctor will ask you to describe your symptoms, the location of any pain, and when the pain occurs.

Tests to check for physical clues of endometriosis include:

Pelvic Exams

During a pelvic exam, your gynecologist will examine the size and position of your ovaries, uterus, cervix, and vagina for abnormalities, such as cysts on your reproductive organs or scars behind your uterus.


Laparoscopy is a relatively quick telescopic examination of the pelvic organs that is done with a general anesthetic. During the examination, a special telescope is inserted just below the belly button or umbilicus into the abdominal cavity, allowing for visual inspection of the ovaries, uterus, fallopian tubes, bowels, and bladder. Biopsies may be taken to confirm the diagnosis of endometriosis.

Treatment Options for Endometriosis

Treatment for endometriosis is dependent on how severe symptoms are and whether you hope to become pregnant. Most options generally involve medications or surgical procedures.

Pain Medication

Your doctor may recommend over-the-counter pain relievers, which may be combined with hormone therapy if you’re not trying to get pregnant.

Hormone Therapy

Supplemental hormones can be effective in reducing or eliminating the pain of endometriosis. Hormone medication can often slow endometrial tissue growth and/or prevent new implants of endometrial tissue.

Abdominal Surgery

For those who may still hope to become pregnant or have failed to find relief from endometriosis pain with other treatments, surgery may be recommended. This often involves laparoscopic surgery, which is similar to the process typically used to diagnose endometriosis.

Endometriosis Treatment

If you think you may be dealing with signs and symptoms of endometriosis, it’s important that you contact us as soon as possible to set up an appointment. At North Carolina OB/GYN and Midwifery, we truly understand the stress and anxiety that can come with a diagnosis of endometriosis. Your doctor and nurse will work with you one on one to make sure you understand all available options and your best course of endometriosis treatment while protecting your future health

Contact Us for More Information

If you are experiencing discomfort and symptoms that suggest endometriosis, please contact us to schedule a consultation. Living with endometriosis can impact your quality of life, but there is help, contact North Carolina OB/GYN & Midwifery at Holly Springs UNC Healthcare.

FAQs: Endometriosis

What Role Do Hormonal Therapies Play in Managing Endometriosis?

Hormonal therapies are central to managing endometriosis because the condition is driven by estrogen, a female hormone. These therapies aim to reduce or eliminate estrogen production in the body, thereby slowing the growth of endometrial tissue and alleviating symptoms. Common hormonal treatments include birth control pills, gonadotropin-releasing hormone (GnRH) agonists, and progestins, which can regulate or suppress menstrual cycles, reduce, or eliminate menstrual flow, and decrease inflammation and pain.

What Are the Potential Side Effects of Managing Endometriosis with Hormone Therapy?

Potential side effects associated with hormonal therapies may include nausea, weight gain, mood changes, headache, breast tenderness, and irregular bleeding. GnRH agonists can also induce a temporary menopause-like state, potentially leading to hot flashes, vaginal dryness, and bone density loss.

Can Endometriosis Recur After Treatment, and What Are the Long-Term Management Strategies?

Yes, the recurrence rate varies depending on the treatment method, but it is not uncommon due to the chronic nature of the disease. Long-term management strategies may include continuous hormonal therapy to suppress the growth of endometrial tissue, regular monitoring of symptoms, and surgical interventions if necessary. Pain management techniques, including both medication and alternative therapies like physical therapy or acupuncture, may also be part of a comprehensive long-term strategy.

How Do Genetics and Family History Influence the Risk of Developing Endometriosis?

Genetics and family history are significant risk factors for developing endometriosis. Research indicates that individuals with a first-degree relative (mother, sister, or daughter) who has endometriosis are at a higher risk of developing the condition themselves. This suggests a genetic component to the disease, although the exact genetic markers and how they contribute to the condition are still being studied. Understanding the genetic links to endometriosis helps in identifying those at risk earlier and potentially guiding future treatments and preventive strategies.

Can Lifestyle Changes or Dietary Modifications Alleviate Symptoms of Endometriosis?

Lifestyle changes and dietary modifications can indeed play a role in alleviating symptoms of endometriosis, although they are usually considered complementary to medical treatments. Regular exercise, stress reduction techniques, and a balanced diet can help manage symptoms. Some individuals find relief by avoiding foods that may exacerbate inflammation, such as red meat, gluten, and high-fat dairy products, and by increasing the intake of foods rich in omega-3 fatty acids, fruits, vegetables, and whole grains.

What Are the Advancements in the Surgical Treatment of Endometriosis, and How Do They Compare to Traditional Methods?

The advancements in the surgical treatment of endometriosis include minimally invasive techniques such as laparoscopic surgery and robotic-assisted surgery. These methods allow for precise removal of endometrial lesions with smaller incisions, resulting in shorter hospital stays, less post-operative pain, and quicker recovery times compared to traditional open surgery. Techniques such as nerve-sparing surgery have also been developed to reduce the risk of damage to surrounding nerves, potentially decreasing post-operative complications, and preserving fertility. Advanced imaging techniques during surgery can help identify and remove lesions more effectively. Ultimately, the treatment approach is determined by the patient’s specific case details.