With Erin Stone, MD, FACOG, Tryon Medical Partners
Have you ever found yourself doubled over in pain during your period, wondering if this level of discomfort is really “normal”? Or perhaps you’ve been told to “tough it out” when monthly pain forces you to miss work or social events? You’re not alone. While some degree of period discomfort is common, for millions of women, the pain they’re experiencing could be a sign of something more serious: endometriosis.
Approximately 10% of women are affected by this condition, yet many suffer in silence for years before receiving a diagnosis. Dr. Erin Stone, a gynecology and sexual health expert specializing in women’s health at Tryon Women’s Center in Charlotte, N.C., shares vital information about this often-misunderstood condition, from its earliest warning signs to the latest treatment options.
“One of the most challenging aspects of endometriosis is that many women don’t realize their symptoms aren’t normal,” Dr. Stone notes. “They’ve been told that severe period pain is just part of being a woman, when in reality, it could be a sign of a condition that needs medical attention.”
What exactly is endometriosis and what causes endometriosis pain and symptoms?
Dr. Stone explains that endometriosis occurs when the glandular tissue typically found in the uterus appears outside the uterus itself. This tissue can become implanted in various places, even reaching as far as the diaphragm or chest region. It causes significant pain, bleeding, and inflammation.
The condition can be particularly challenging to diagnose because symptoms vary widely among patients, and as Dr. Stone points out, “The degree of symptoms doesn’t always correlate with the severity of endometriosis. Sometimes it takes surgery to determine how severe it is internally – we have to listen carefully to each patient’s history.”
What are the signs of endometriosis?
One of the most distinctive features of endometriosis is its debilitating impact on daily life. People with endometriosis might experience nausea or vomiting, severe pelvic and back pain even mid cycle, pain during bowel movements, and even cyclic fevers. These symptoms are often disruptive and Dr. Stone says if you have to regularly miss school, practice, or work because of your period, it may be a clear sign of endometriosis.
Many patients also experience what’s known as “endo belly” – a common term in the endometriosis community describing the significant bloating and gastrointestinal symptoms that can accompany endometriosis. “Endo belly” can be particularly distressing for patients, often causing visible swelling and discomfort. This can include inflammation in the GI tract, constipation, diarrhea, and even bloody stools.
If you have an immediate family member with endometriosis, the risk of you developing endometriosis increases. This is also true of getting your period before the age of 11. However, having children and breastfeeding, which suppresses the hormones that cause endometriosis symptoms, can be protective.
The menstrual cycle itself can provide important clues: “Sometimes patients experience heavier periods, while others have irregular cycles,” Dr. Stone explains. “Short cycles of less than 27 days can be a risk factor for endometriosis.”
What are the available endometriosis treatments?
Thankfully, there are several approaches to managing symptoms:
First-line treatments, especially for adolescents, typically begin with anti-inflammatory medications like ibuprofen. However, Dr. Stone notes that “patients often need additional intervention, such as hormonal suppression to prevent the ovaries from releasing estrogen, which drives the inflammation.”
Management options include:
- Hormonal treatments: Birth control pills, skin patches, or low-dose progestin
- Long-acting reversible contraception (LARC) devices: Including intrauterine devices (IUDs) and progestin arm implants
- Surgery: For removing endometrial lesions, which can provide 3-5 years of relief
- Lifestyle modifications: For instance, anti-inflammatory exercise which can help significantly with symptom management. Dr. Stone shares. “Getting more than four hours of exercise weekly can notably reduce endometriosis symptoms.”
Additional supportive measures include:
- Yoga and meditation
- Acupuncture
- Proper hydration
- Anti-inflammatory diet modifications
- Key supplements: Vitamin C, Vitamin D, Zinc, and Omega-3
What are the long-term effects of endometriosis?
Can endometriosis cause infertility?
The answer is yes – fertility issues are a major concern with endometriosis. While 10% of women have endometriosis, that number jumps to 38% among fertility patients. It’s crucial to discuss fertility early because untreated endometriosis can lead to complications. Many patients are hesitant to take medication, but without treatment, you can face fertility consequences including scarred fallopian tubes
Can endometriosis cause cancer?
While rare, endometriosis can occasionally lead to cancer, particularly in the ovaries and appendix. “When the ovary is affected by what we call an endometrioma, there is a small risk it could develop into cancer,” Dr. Stone explains. “During surgery, we always examine the appendix and remove any endometriomas larger than 3 centimeters as a precaution.”
Can endometriosis cause weight gain?
According to Dr. Stone, while endometriosis itself isn’t directly linked to weight gain, there can be indirect effects. “We don’t usually discuss weight gain as a primary symptom, but there is probably a correlation with the mental health impacts of chronic pain and inflammation, which can lead to weight changes. Some patients find their weight becomes more difficult to manage even with treatment.”
Can endometriosis go away on its own?
Endometriosis will not go away on its own until menopause, which typically occurs between 45-55 years of age. The only other way to control it is through hormone suppression treatments, which is why early intervention and consistent management are so important.
“In severe cases,” Dr. Stone adds, “We can remove gonads and ovaries or suppress them completely with medications to initiate chemical menopause.”
When should you seek medical attention?
Dr. Stone recommends seeking medical attention if you experience:
- Periods that regularly cause you to miss work, school, or daily activities
- Severe pelvic or back pain
- Pain with deep penetration or intercourse
- Gastrointestinal symptoms that worsen during menstruation
- Pain during bowel movements
- Irregular or extremely heavy periods
“Most importantly,” Dr. Stone emphasizes, “trust your body and your experiences. While endometriosis often can’t be seen on standard imaging, your symptoms and history are valid and important for diagnosis and treatment.”
Remember that early intervention can help manage symptoms more effectively and potentially prevent some long-term complications. If you suspect you might have endometriosis, don’t wait. Make an appointment with your primary care clinician or gynecologist to learn more about improving your symptoms.
Tryon Medical Partners is an independent medical practice dedicated to maintaining trusted patient-doctor relationships, providing excellent and personalized care, and giving you the choices in healthcare that you deserve. With eight convenient locations throughout Charlotte, Tryon Medical Partners specializes in primary care as well as cardiology, dermatology, gynecology, endocrinology, gastroenterology, pulmonary, rheumatology and sleep medicine.
