by Angie Best-Boss, Contributing Writer

“The hardest part is that it took so long to get a diagnosis. I’ve been told that cramps are normal; take some Tylenol or try Midol if that doesn’t work; that I have a low pain tolerance (I found that funny); and even “It’s all part of the joys of being a woman”. After talking with a friend she told me about her cousin who just had to have surgery for endometriosis.

My mother has always kept a physician’s desk reference in the house, so I looked it up. It was a wonderful book with symptom checkers. I found the page on endometriosis and as I started answering yes to the questions, I burst into tears. I’m not crazy….I finally had an answer.” Karen, who got diagnosis after four years of symptoms.

Endometriosis is a common medical condition in which the tissue lining the uterus is found outside of the uterus. Painful menstruation and infertility are two of the numerous symptoms, and it can take up to eight years to diagnose. A serious disease associated with pain, immune dysfunction, infertility, cancer, and autoimmune diseases it can be managed only through active, informed decision-making, explains the Endometriosis Association.


Over 4 million women in the US and Canada have endometriosis and there is no confirmed cause, although it does run in families. The longer that this disease goes undiagnosed the more damage it can do. It is well documented that for many women, it can take anything up to ten years to finally get a true diagnosis. The only way to officially diagnose endo is by visually inspecting the abdominal organs with a laparoscopy.

Endometriosis is categorized into four stages based on the severity, location, amount, depth and size of growths.

• Stage 1 – minimal disease, superficial and filmy adhesions
• Stage 2 – mild disease, superficial and deep endometriosis
• Stage 3 – moderate disease, deep endometriosis and adhesions
• Stage 4 – severe disease, deep endometriosis, dense adhesion

Symptoms include:

• painful periods
• pain with intercourse
• painful bowel movements
• painful urination
• infertility
• nausea
• pelvic pain at times other than at menses
• bloating
• fatigue.


Infertility affects around 40% of women with endometriosis. Endo may also cause you to have a higher chance of miscarriage. Medication helps some women with endometriosis. The first line of defense is often birth control bills (which may take some trial and error) to determine the best fit or the depo-Provera injection.

Some physicians advocate medical suppression with a GnRH-agonist such as Lupron, Synarel, or Zoladex for up to 6 months after surgery for severe endometriosis before attempting conception. Although at least one published study found this to improve pregnancy rates as compared to surgery alone, other studies have shown no benefit, explains Dr. Robert Sherbahn of the Advanced Fertility Center of Chicago.

Many doctors feel that for a woman who has Endometriosis, the best chances of pregnancy occur during the six to nine months period following treatment with a laparoscopy procedure.

For the treatment of infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination is often attempted and has a reasonable chance to result in pregnancy. If it doesn’t work after a maximum of six cycles, you’ll need to move on and consider if in vitro fertilization is an option.

Complementary treatment

The Endometriosis Natural Treatment Program: A Complete Self-Help Plan for Improving Health and Well-Being by Valerie Ann Worwood outlines a program for eliminating certain foods, changing habits, and using supplements and essential oils to begin healing the condition, incorporating aromatherapy, diet, sitz baths, and other methods. Worwood suggests slow yet steady lifestyle changes that focus on whole, unprocessed foods, detoxification, self-massage, essential oils, stress reduction, herbal remedies, and supplements to address nutritional needs.

Find Support

Because endometriosis is so challenging to live with, find ways to create as much support as possible. Being involved in online support groups and forums will also help keep you informed of new treatments, research and information you need to know. They can also be sources of referrals for knowledgeable healthcare providers. Sites like http://www.endo-resolved.com are a good place to start.

To learn more about Endometriosis

Endometriosis.org is the global platform that links all stakeholders in endometriosis. It facilitates collaboration and information sharing between women with endometriosis, physicians, scientists, and others interested in the disease.

This international cooperation and exchange of experience enable us to deliver up-to-date, evidence-based, information and news about endometriosis.

The Endometriosis Research Center was founded because of the limited research, support, education and awareness of Endometriosis. No one with this disease should ever feel alone, and one of our goals is to create enough awareness to ensure that women and adolescents – and their loved ones – never have to feel that way again.

Endometriosis Research at the National Institutes of Health

Daftary GS and Taylor HS. EMX2 gene expression in the female reproductive tract and aberrant expression in the endometrium of women with endometriosis. J Clin Endocrinol Metab 2004, 89(5):2390- 2396.

Taylor HS, Bagot C, Kardana A and Arici A. HOX Gene Expression Is Altered in the Endometrium of Women with Endometriosis. Hum Reprod 1999, 14(5):1328-1331.

Dmowski, W.P., Braun, D.P. Immunologic Aspects of Endometriosis. In: Endometrium and Endometriosis. Walden, MA, Blackwell Science. pp. 174-181, 1997

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