Endometriosis �Overloo�ed and �nderestimated
Ber�en Ne� Brid�e �edi�al Dire�t�r Details S�m�t�ms and Treatments
�aglaa�iz� , M� , is Medical �irector for Am�ulatory Services at �ergen �e� �ridgeMedical Center and an Assistant Professor for the �epartment of O�stetrics , Gynecology , and �omen�s Health at �utgers�e� �ersey Medical School .
PHOTO CO��TESY O� �E�GE� �E� ��I�GE ME�ICA� CE�TE�
�aglaa Rizk , MD , Medical Director for Ambulatory Services at Bergen New Bridge Medical Center and an Assistant Professor for the Department of Obstetrics , Gynecology , and Women ’ s Health at Rutgers New Jersey Medical School provides the following information .
Q . What isendometriosis ? �� . ������ ���� : Cells from the lining of theuterus �endometrium� that areexpectedtobeexpelled during menses end up somewhere they should not be . Most often , these cells form clumps �called implants� foundinthe pelvis , around the uterus , inthe fallopian tubes , and in the ovaries . These cells can also be located anywhereinthe body�except the spleen� . When these endometrial cells are found inthe body of the uterus , the condition is called adenomyosis . When they form acyst onthe ovary , itiscalled an endometrioma .
Q . What are the symptoms ? �� . ���� : Dependingonthe location of theendometriotic implant , symptoms may differ . The most common symptom is pain , usually pain that starts days before menstruation , butthe pain often radiates to the back / hips / thighs . Over time , pain maybenon- cyclic and persistent . Many women have pain with intercourse , with bowel movements , with urination . Othercommon symptoms include : � Bloating � Nausea � Changes in bowelhabits with menses � Swelling � Fatigue � Insomnia � Migraines � “ Brain fog ” � Depression�from beinginchronicpain� � Anxiety from guilt when havingtocancel plans
�duetopain� � Excessive bleeding or changes in bleeding patterns �especiallywithadenomyosis�
Because of all the possible symptom patterns , endometriosisisoften called the “ greatmimic .”
Q . �ow common isit ? Is it hard to diagnose ? �� . ���� : The published literatureis10� -15 �of women between ages 25-40 . However , this is likely a gross underestimate because many women are undiagnosed . �My personalincidence is 5�� of all surgeriesdone forany reason . �
It can be diagnosed using avery detailed history and exam . Otherwise , insome institutions , itmay be noted on ultrasound or MRI . Traditionally , it has been diagnosed by surgery , but that isnolonger necessaryfor all women .
Unfortunately , women are oftenundiagnosed or misdiagnosed as having Irritable Bowel Disease or other syndromes depending on the specialist they see for theirsymptoms .
Q . What can be done to treat it ? �� . ���� : The first stepisdiagnosis . Because endometrial cells react to hormones , treatment generally involves hormones as well . Sometimes surgery is necessary .
Q . What age range does it affect ? �� . ���� : Generally affectswomen whoare menstruating . However , there are cases of endometriosis found inpre-pubertal girls and post-menopausal women .
Q . Why is understanding it an important part ofwomen ’ s wellness ? �� . ���� : Endometriosis is so varied thatitmay be a source of symptoms that donot appear to be related . Untreated , it drastically distorts awoman ’ s quality of life and well-being : from emotional connections to attending social events to sexual satisfaction and self-esteem .
Q . What other effects can it have on a woman ’ s health ? �� . ���� : �eftuntreated , endometriosiscan be a leading cause of infertility . Also : chronic pain can be incapacitating and result in disability that precludes having fulfilling relationships with family / friends or even completing educationorgetting / maintaining a job .
Q . �nything else you think isimportant to know ? �� . ���� : Itisimportant to seeaprovider whospecializes in endometriosis ifyou feel your symptoms may berelated or if you have seen multiple providers without successful therapy . Takecharge of your health .
Call 201-���-4000 or visitne��ri�gehealth . org for more information .
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