The Link Between Endometriosis and Pelvic Pain

You have a condition called endometriosis, and it’s causing you a good deal of pain. You’re not alone. Approximately 10% of women in their reproductive years develop endometriosis, and many of them are experiencing the same discomfort as you.

One of the best ways to combat the pain of endometriosis is to first understand why it develops, which can help guide you in choosing your treatment options. To that end, Dr. Gary Willen and the team here at Tahoe Women’s Care are taking a closer look at the relationship between endometriosis and pelvic pain in this month’s blog post.

Endometriosis 101

When you have endometriosis (or endo), the tissue that normally lines the inside of your uterus — your endometrium — grows outside of the organ. This misplaced tissue can grow in many different places, such as your:

• Ovaries
• Fallopian tubes
• Exterior of your uterus
• Connective tissue that hold your uterus in place
• Cervix
• Vagina 
• Bowel
• Rectum
• Bladder

The problem is that this tissue acts as if it were inside of your uterus, thickening with each menstrual cycle. When it comes time to shed out, however, these implants have nowhere to go, and they can slowly form adhesions (scar tissue) that can cause pain and discomfort.

Characterizing the pain of endometriosis

Pain is generally the hallmark of symptomatic endo, but how this pain presents itself can vary greatly.

For example, you may only feel pain (or it may worsen) when you’re having your period, which makes sense given that the tissue is thickening. 

When implants form, these tough tissues can cause pain during certain activities, depending on their location. Many women complain of heightened pain during and after sex, while others feel discomfort when they have a bowel movement.

Endometrial implants can also lead to ongoing pain, most often described as a dull ache in the pelvis or lower back.

Again, how the pain presents itself varies from one woman to the next, as it depends entirely on where the adhesions are located, how they’ve attached themselves, and the number of implants that have developed.

Treating endometriosis

There are many ways to treat endometriosis, and your options depend on the extent of the problem and your goals.

One frontline treatment we can use is hormonal medications that regulate your menstrual cycles. By introducing certain reproductive hormones, we can control the behavior and new development of misplaced endometrial tissue.

If, however, you’re actively trying to have children, this approach may not be a good one, as the medications work like birth control. 

In these cases, we may recommend other options, including having us remove the problematic tissues surgically. We use the latest techniques, including the cutting-edge da VinciⓇ robotic surgical system, which allows us to remove the implants through only a few small incisions.

Another approach that may resolve your endo, but preserve your fertility, is to send you into a temporary menopause with gonadotropin-releasing hormone medications. Once your body registers the medication-induced menopause, the endometrial tissues should dissipate and, once they do, we take you off the medications so you can resume your menstrual cycles again.

If you’re struggling with endometriosis-related pain and you’d like to explore your treatment options, contact our office in Carson City, Nevada, to set up an appointment.