Treatments Improving For Endometriosis
Women with pelvic pain or menstrual difficulties need to be aware of the possibility of endometriosis, an inflammatory disease that can cause multiple medical problems and interfere with fertility, say two doctors at the Kaiser Permanente Medical Center.
Treatments are improving, and women with the disorder, a leading cause of infertility, are now often able to conceive and bear healthy children, say Dr. Miya Yamamoto and Dr. Joan Manglicmot. While March was Endometriosis Awareness Month, it’s a good idea to get checked whenever you’re suffering frequent pelvic pain or other symptoms, they said.
Dr. Manglicmot, an emergency room doctor, gave birth to her first child, now three months old, after having her endometriosis treated by Dr. Yamamoto, an endometriosis specialist with Kaiser.
Endometriosis affects between 2 and 11 percent of American women. It occurs when tissue similar to that found in the uterus (or womb) grows elsewhere, usually in the pelvic region. According to Yamamoto, it can cause inflammation and the formation of scar tissue, leading to pain, interference with bowel and bladder function, and difficulty conceiving.
“I’d never been to an OB-GYN (specialist in women’s health) when I was young,” Manglicmot said. “But as I got older and wanted to start a family, the pain got even worse. It was debilitating. I was really doubling over in pain, and it wasn’t always related to my period.”
She checked with an OB-GYN, had a pelvic exam, and learned she had a cyst in her ovary that needed to be removed or resected to use the proper medical term. The ultrasound then revealed the endometriosis.
“You never know what you’ll find with endometriosis until you go in surgically,” Yamamoto said.
She said that endometriosis is often fought by suppressing hormones that also aid fertility, sometimes by the use of birth control pills.
Manglicmot subsequently conceived naturally, but she miscarried. She was treated for endometriosis, but the treatment was paused long enough for her and her husband, Moawia Nasir, to conceive their son Veid. She had a normal pregnancy, and Veid was born healthy.
Seeing your primary OB-GYN is the first step in finding out whether any pain or discomfort is normal, Yamamoto said. Adult women at Kaiser have a primary OB-GYN as well as a primary care physician.
Teens, who are often still seeing a pediatrician, sometimes have painful first few periods, but pediatricians are quite comfortable talking with them about this. Normally, pediatricians share medical information for patients up to age 21 with parents. Yamamoto said that teens can also contact one of Kaiser’s Teen Clinics, where some confidential visits are available.
Kaiser recommends cervical cancer screening at age 21, with pelvic exams. Yamamoto said the first onset of endometriosis symptoms often occurs in a woman’s early twenties, and can also occur when a couple first try to conceive and discontinue birth control.
It’s not only birth control that can help suppress endometriosis symptoms, Yamamoto said. Pregnancy itself or breastfeeding can be affected by the hormones released by both.