Conditions and Management

Endometriosis is a common disorder in women . The inside of your uterus is lined with tissue called the endometrium. The endometrium thickens to provide a cushion for an egg released from your ovary during ovulation, if the egg is not fertilized, the endometrium breaks down and bleeds with your menstrual cycles. Your body expels the tissue along with any unfertilized egg through the vagina.

Endometrial-like tissue may grow outside of the uterus.. It usually affects your pelvic organs such as the ovaries, fallopian tubes, and the tissue lining your pelvis, but it can affect any other organ. This abnormal tissue growth is the condition known as “endometriosis”.

Endometriosis causes pain, especially during the menstrual cycle. How and why endometrial tissue is able to get to other organs in the body is unknown; however, medical researchers have determined that endometriosis tends to run in families. They have also found that it occurs more often in women who have fewer than 25 days between periods or who menstruate for more than seven days. Those women are twice as likely to develop endometriosis. Researchers also believe that exposure to certain industrial chemicals can be a cause.

Common Symptoms of Endometriosis

The abnormal tissue works much the same way normal endometrial tissue does by thickening, breaking down, and bleeding. However, when the endometrial-like tissue breaks down and bleeds with your menstrual cycles, your body has no way to expel it, therefore becoming trapped in your body.

Over time, the tissues can form cysts or endometriomas, on your ovaries. It can also irritate surrounding tissues and cause scar tissue and adhesions. Adhesions are abnormal bands of fibrous tissue, often causing pelvic tissues and organs to stick to each other.

How do you know if you have endometriosis? The symptoms are common symptoms of other conditions, and women may or may not experience any of them. The symptoms are vague and similar to the symptoms of other disorders. It is not unusual for women to have endometriosis and even experience symptoms for many years before it is diagnosed and treated. If you suspect that you have endometriosis, you should have your doctor perform a pelvic exam to diagnose.

Some common symptoms of endometriosis include:

Pelvic Pain; Painful Periods

Excessive pelvic pain or cramping along with menstrual periods is a telling symptom. Cramping or pain is normal for most women during their cycle; however, women with endometriosis will experience pain and cramping that is more than the usual discomfort associated with a normal menstrual cycle.

In many cases, it far exceeds what is normal and often increases over time. Note that the severity of the pain is not an indication of the severity of the endometriosis. Some women have mild endometriosis but experience severe pain, while others may have advanced endometriosis with little or no pain. Researchers believe that the pain probably comes from the scarring and irritation caused by bleeding, or from endometrial tissue growing on a nerve.
If you have pain, it can begin before the onset of your menstrual period and continue for several days. In addition to the abdominal pain, some women experience lower back pain.
Pelvic pain or lower back pain is not necessarily caused by endometriosis. Other disorders can cause pelvic pain.

Examples of other painful conditions include pelvic inflammatory disease (PID) or ovarian cysts that were not caused by endometriosis, or irritable bowel syndrome (IBS), which causes bouts of diarrhea, constipation, and abdominal cramping. Sometimes, these other conditions can exist along with endometriosis.

Pain During Intercourse

Another common symptom is pain during or after sexual intercourse. The depth and intensity of the pain can vary based on your sexual position and where you are in your menstrual cycle.

Excessive Bleeding

Heavy menstrual periods or bleeding between periods is a common indication of endometriosis.

Pain with Bowel Movements or Urination

With endometriosis, some women experience pain with their bowel movements or urination during a menstrual period.

Infertility

If you are having trouble getting pregnant, have your doctor examine you for the possibility of endometriosis. It is not unusual for the endometriosis to go undiagnosed until a woman seeks treatment for her infertility.

Other

Some women can experience general fatigue and digestive symptoms such as diarrhea, constipation, bloating or nausea, especially during your menstrual periods.

Contact Raleigh Gynecology for More Information

The symptoms of endometriosis can be difficult to pinpoint causing the condition to exist for a long time before it is finally diagnosed. During that time, it can impair the woman’s ability to become pregnant and can pose other serious risks to her health. It is important to contact and discuss your symptoms with the women’s health specialists at Raleigh Gynecology, and have it diagnosed and treated as early as possible.

Endometriosis is a condition that afflicts many women. It is a disorder involving endometrial tissue, which is the type of tissue that lines the inside of a woman’s uterus. So, how do you diagnose endometriosis?

When you ovulate, your ovaries release an egg into your uterus where the endometrium lining thickens to provide a cushion for the egg. If the egg is not fertilized, the endometrium breaks down and bleeds out during your menstrual cycle. Menstrual bleeding is your body’s way of expelling the endometrial tissue along with any unfertilized egg.

Endometriosis occurs when microscopic bits of endometrial tissue escape from your uterus, attach to other organs in your body and grow. Endometriosis usually affects organs in your pelvic area, ovaries, fallopian tubes and the tissue lining your pelvis, but it can affect other organs in your body.

Symptoms Of Endometriosis

How do you know if you have endometriosis? Some of the most common symptoms are:

Pain And Cramping

The endometrial tissue growing outside of your uterus acts like normal endometrial tissue through each menstrual cycle. It thickens, breaks down and bleeds along with the healthy cells making up your endometrial lining; however, your body has no way to expel the abnormal cells once they break down and they become trapped. With no way to escape the body, they can form cysts called endometriomas, irritate other organs and tissue, and develop scar tissue and adhesions that cause pelvic tissues and organs to stick to each other. This process causes pain and cramping, which is often severe. You may also have pain and cramping during sexual intercourse and with bowel movements or urination when you are menstruating.

Excessive Bleeding

Women with endometriosis often experience heavy menstrual periods or occasional bleeding between periods.

Infertility

Infertility is a common symptom of endometriosis. Treatment has to be tailored to the condition of each patient. In some cases, endometriosis may be affecting the function of the patients’ fallopian tubes, which requires a much different treatment from cases where endometriosis is interfering with the ovaries. Women experiencing infertility may need to be evaluated and treated for endometriosis to optimize their chances to conceive.

Other

During your menstrual periods, you may experience unusual fatigue, diarrhea, constipation, bloating or nausea.

These symptoms can be vague. Some women with extensive endometriosis will have few symptoms, while other women with a mild case can experience severe symptoms.

How to Diagnose Endometriosis

Diagnosing endometriosis can be difficult, especially when you have few if any symptoms. The symptoms also make the condition easy to mistake for other types of health disorders such as irritable bowel syndrome or ovarian cysts.

If left undiagnosed and untreated, endometriosis can present serious health risks. It can lead to infertility and interfere with the healthy functioning of other organs. If you are experiencing any of the symptoms described above, talk with your doctor about appropriate evaluation and treatment for your symptoms.

Diagnosis involves a multiple step process, beginning with the least invasive and progressing to more invasive surgical procedures:

Pelvic Exam

The first step in diagnosing endometriosis is a pelvic exam by your gynecologist. During a manual examination of your pelvic area, your gynecologist will feel the organs in your pelvic area for abnormalities. Sometimes, your gynecologist can feel cysts, scar tissue, or other abnormal growths; however, if no such abnormalities have yet formed, manual examination is inconclusive.

Ultrasound of Your Pelvic Region

If your endometriosis symptoms persist, your gynecologist may recommend an ultrasound test. It uses high-frequency sound waves to create images of the inside of your pelvic region. It may be performed by pressing a device called a transducer against your abdomen or inserting it into your vagina. For the best results, both types of ultrasound can be conducted to get the most comprehensive view of your organs. The ultrasound can identify and locate any endometrial cysts that have formed, which may not be detectable through manual examination.

Magnetic Resonance Imaging (MRI)

Using a magnetic field and radio waves to create detailed images of the organs and tissues within your body, an MRI can give your gynecologist a comprehensive view of cysts and scar tissue that can help in planning surgery.

Laparoscopy

The most definitive diagnostic exam for endometriosis is a laparoscopy. It is a procedure that allows a surgeon to view inside your abdomen. During a laparoscopy, you will be under general anesthesia. The surgeon makes a tiny incision near your navel and inserts a slender viewing instrument called a laparoscope, enabling the surgeon to look for signs of endometrial tissue outside the uterus.

A laparoscopy can provide detailed information about the location, extent and size of any endometrial cysts and tissue, along with any adhesions and scar tissue. Often, your surgeon will take tissue samples to test for endometriosis and to rule out malignancies or other abnormal conditions. A laparoscopy is also useful because your surgeon may be able to fully treat endometriosis during the laparoscopy, helping to improve the problems that endometriosis has created.

Visit Your Gynecologist

Stay on top of your reproductive health, have regular pelvic exams by a gynecologist and stay alert to the symptoms of endometriosis. If you have been trying to get pregnant for a while without success, endometriosis could be the problem. Your gynecologist can help you address those issues.

Contact Raleigh Gynecology

Endometriosis is a serious health condition that often escapes early diagnosis. Regular pelvic examinations can help identify it early and manage it before it becomes a bigger risk to your health. If you are having symptoms of endometriosis or have any questions about it, contact the women’s reproductive and health experts at Raleigh Gynecology.

Mammograms are an important, non-invasive tool for identifying changes in your breast tissue and early detection of cancer. Knowing how often you should get a mammogram can help you to stay healthy as you age.

What Is A Mammogram?

A mammogram is an x-ray of the breast. It is performed using a safe, low-dose x-ray machine designed to take images of your breast tissue.

Risks And Benefits Of Mammography

The benefits of mammography are significant for women between age 40 and 70, as well as for those women at higher risk of cancer. The most significant benefit is that a mammogram can detect breast cancer at an early stage. Early detection improves a woman’s chance of survival, reducing the risk of dying from the disease by 25-30% or more. Having a mammogram done regularly provides a simple way for a woman and her doctor to monitor changes in her breast health over long periods of time.

For most women, the benefits outweigh the risks which include overdiagnosis and overtreatment. This occurs when a mammogram finds ductal carcinoma in situ (sometimes referred to as “DCIS”) or a small breast cancer that would have never caused symptoms or problems if left untreated. These types of breast cancers may never present a health problem, or a person may die from another cause before the breast cancer became a problem.

Other risks include false positives which require the patient to undergo additional testing, such as an MRI, ultrasound or biopsy to diagnose a possible issue. In most cases, the abnormality is not cancer.

The Necessity Of Mammograms

According to the Center for Disease Control (CDC), breast cancer is the second most common type of cancer in women in the United States. For many women, a mammogram is one of the best ways to detect breast cancer before it becomes life threatening.

A mammogram can detect abnormal breast tissue as much as two years before it becomes cancerous. It can also detect it before it becomes large enough to be felt through a manual examination of the area.

If your mammogram shows abnormal tissue, you will likely have to undergo additional testing. This testing may include an ultrasound of the breast or an MRI for a more detailed image of the area of concern identified in the mammogram. In some cases, you may have to undergo a biopsy procedure to remove a sample of the abnormal breast tissue and have it laboratory tested to determine if the tissue is cancerous.

Mammography Recommendations Based On Age

Breast cancer in women younger than 50 is much less common than in older women. As women age, however, their risk of developing breast cancer increases. For most women of any age, a mammogram every one to two years is beneficial, with some exceptions as described below:

Recommendations For Women Under Age 40

For women under age 40, mammograms are recommended only if abnormalities in the breast tissue have been detected through manual examination or other testing. The breast tissue in younger women tends to be dense which can obscure signs of cancer, making detection by mammography difficult and unreliable.

As women age, dense breast tissue becomes less of an issue. With age, the breast tissue becomes fattier and less dense.

Recommendations For Women Age 40-49

After age 40, a mammogram is more reliable in helping to detect breast cancer. That said, leading health organizations disagree to some degree on when to begin getting mammograms and how often they should be repeated.

The American College of Obstetricians and Gynecologists (ACOG) recommends screening mammography every 1–2 years beginning at age 40 years for women at average risk of breast cancer. Screening should continue until at least age 75 years.

The United States Preventive Services Task Force, the American College of Physicians and the American Cancer Society recommend that women in the 40-49 age group discuss the need for a mammography with their doctors, and make informed decisions based on the woman’s risk profile, concerning when she should start mammography screening and the frequency.

The most important factors in that decision will be the woman’s individual cancer risk profile, family history and personal preferences about the health risks presented by a mammography. If breast cancer runs in your family, you should begin mammography screening by age 40, and some women at very high risk may need to begin screening even sooner.

Recommendations For Women Age 50-69

For women ages 50-69, the benefits of mammography easily outweigh the risks. Women in this age group realize the most overall benefit of mammography because the condition of their breast tissue makes mammograms more reliable. Women aged 50-59 who got mammograms had a 14 percent lower risk of dying from breast cancer than those who did not have a mammogram. Women aged 60-69 who had mammograms, had a 33 percent lower risk of dying from breast cancer than those who did not have one.

Most leading health organizations agree on the recommendation that women ages 50-69 have regular mammograms. At Raleigh Gynecology and Wellness, we recommend that women in this age group continue to have a mammogram every year in addition to monthly self-examinations.

Recommendations For Women Over Age 70

For many women age 70 and older, regular mammography every one to two years continues to be beneficial. For some women over 70, however, the benefits of mammography may not be worth the risks.

In this age group, mammograms can result in overtreatment and subject elderly women to the risks of harmful side effects of breast cancer treatment.

Also, women aged 70 to 75 are more likely to die from other causes than from early stage breast tumors detected through mammogram screening. When breast cancer is diagnosed, the treatment can be difficult for an elderly woman to endure. Some women are at increased risk for complications from surgery and for side effects caused by chemotherapy and hormone therapy. Women in this age group should discuss the risks and benefits with their doctor to decide whether the benefits of regular mammograms outweigh the risks in their individual case.

Regularity In The Procedure Is Best

Routine mammography decreases the risk of death from breast cancer by 30 to 48%. Medical research has shown that the vast majority of deaths due to breast cancer occur in women who have never had mammographic screening.

Regular mammography helps detect cancers that grow very quickly. Fast growing cancers can spread to your lymph nodes even while they are still small and are even able to double in volume in just one month. Keeping up with regular mammograms can prevent this kind of cancer from becoming deadly.

Talk To The Mammogram Professionals At Raleigh Gynecology And Wellness

If you have questions about the risks and benefits of regular mammography screening, contact the mammogram specialists at Raleigh Gynecology and Wellness. They are available to answer your questions. If you have breast cancer in your family or you are over age 40 and have never had a mammogram, contact us to schedule an appointment. You can also reach us by phone at (919) 636-6670.

Endometriosis is a common disorder of a woman’s uterus. It typically affects the pelvic organs ovaries, fallopian tubes, bowels, bladder, rectum, and the tissue lining your pelvis, but it can affect any other organ in your body.

Endometriosis implants respond to changes in estrogen, a hormone in a woman’s body. Endometriosis cells respond to your menstrual cycle and bleed just like the normal endometrial cells lining the inside of your uterus. Endometrial cells in your body or on your organs cause inflammation and discomfort and can interfere with the normal functioning of the affected organs.

In some cases, endometriosis can block your fallopian tubes and it can also cause cysts in your ovaries (endometriomas). It can form scar tissue and adhesions that can bind your organs together in ways that can cause significant pain and quality of life issues for you.

Common Causes of Endometriosis

Endometriosis affects about 10% of American women between 15 and 44. It is not a condition that can be prevented. Despite the prevalence of the disease, medical researchers are uncertain about the precise causes of endometriosis; however, it tends to run in families. It also occurs more often in women with certain menstrual patterns. Common theories of the causes of endometriosis include:

Retrograde Menstruation

One long-standing theory on the cause of endometriosis is called “retrograde menstruation”.
In a normal ovulation cycle, your uterine lining—the endometrium— thickens just before ovulation to provide a cushion for an egg released from your ovary. If the egg is not fertilized, the endometrium breaks down and bleeds with your menstrual cycles. Your body expels the endometrial tissue along with any unfertilized egg through the vagina.

Retrograde menstruation occurs when menstrual blood flows back through your fallopian tubes into your pelvic cavity instead of leaving your body through the vagina. That could allow endometrial cells to reach other organs of your body and attach to them.

Embryonic Cell Transformation

Another possible cause of endometriosis is cell transformation. The theory is your hormones transform the cells outside of the uterus into cells like the endometrial cells lining the inside of your uterus.
Embryonic cell transformation is the theory that small areas of your abdomen convert into endometrial tissue. The basis for that theory is that cells in your abdomen grow from embryonic cells. Embryonic cells can change shape and become endometrial-like cells.

Surgical Scar

Another theory for the cause of endometriosis is a surgical procedure that can release microscopic particles of menstrual blood into the pelvic cavity. It can be any procedure involving the pelvic area, such as a Cesarean section (c-section).

Immune System Malfunction

A faulty immune system could be another culprit. When the body cannot expel the cells through the menstrual process, the body’s immune system may destroy them. However, an immune system that is not healthy may be unable to destroy renegade endometrial cells. In that case, the cells eventually will attach themselves to other organs.

Lymphatic System

Your lymphatic system may transport the endometrial cells out of the uterus and into other parts of your body.

Mullerian Theory

This theory holds that endometriosis actually starts in the woman’s fetal period during the development of her sexual organs. Abnormal cell development of certain ducts (known as Mullerian ducts) may occur and endometrial cells grow outside of the uterus. Those cell tissues then respond with the onset of puberty and hormone releases.

How to Diagnose Endometriosis

You should discuss your symptoms with your doctor. To diagnose it, your doctor may perform one or more of the following procedures:

• Pelvic exam, where your doctor may feel for large cysts or scar tissue behind your uterus.
• Ultrasound or MRI to detect ovarian cysts.
• your doctor may prescribe hormonal medications to reduce pain and lower the amount of estrogen in your body.
• Laparoscopy, a surgical procedure that allows the doctor to observe any growths and take tissue samples for analysis.

Talk to the Experienced Gynecologists at Raleigh Gynecology and Wellness

Endometriosis is a common condition in many women. Symptoms can include pelvic pain, pain with intercourse, abnormal menstrual bleeding, and abnormal bowel or bladder function. It also can interfere with your ability to become pregnant, and if left untreated, can result in infertility. The specialists at Raleigh Gynecology and Wellness are available to answer your questions about endometriosis and talk to you about symptoms and treatment. Contact them today for more information about endometriosis or any other women’s health matter and schedule an appointment.

Endometriosis can be a painful condition for many women. It occurs when microscopic bits of endometrial tissue escape from your uterus, attach to other organs in your body and grow. It usually affects organs in your pelvic area such as ovaries, fallopian tubes, and the tissue lining your pelvis, but it can affect other organs in your body.

Medical experts are not sure exactly what causes endometriosis. Some experts believe that small amounts of menstrual blood containing endometrial cells find ways to pass back through your fallopian tubes and spill into your pelvic cavity, where they can attach themselves to your organs. Other experts believe that women have a genetic predisposition to the condition. Here is more info on how do you test for endometriosis?

Symptoms of Endometriosis

The symptoms of endometriosis resemble symptoms for other common disorders. Also, some women with extensive endometriosis will have few symptoms, while other women with a mild case can experience severe symptoms. All of this makes diagnosing endometriosis difficult.

How to test for endometriosis? How do you know if you have endometriosis? Some of the most common symptoms are:

Unusual Pain and Cramping

Many women experience cramps during their menstrual period. With endometriosis, the cramping may be so painful that it interferes with your daily activities.

The pain and cramping are caused by the endometrial-like cells that are growing outside of your uterus on other parts of your body. These cells create inflammation that can irritate your organs and cause them to stick together.

This endometrial-like tissue acts like the normal endometrial tissue lining your uterus. It thickens, breaks down and bleeds just like the healthy endometrial tissue. However, the healthy endometrial tissue lining your uterus is expelled through your vaginal canal during menstruation; this is not the case with the endometrial tissue growing outside of your uterus. Your body has no way to expel that tissue residue once it breaks down. The spent tissue becomes trapped and with no way to escape the body, it can form cysts, called endometriomas, irritate other organs and tissue, and develop scar tissue and adhesions.

You may also have pain and cramping during sexual intercourse and with bowel movements or urination when you are menstruating.

Excessive Bleeding

Women with endometriosis often experience heavy menstrual periods, longer than normal periods, or bleeding between periods.

Lower Back Pain During Menstruation, Bloody Urine or Stools, or Bleeding from the Rectum
If you only experience these symptoms during menstruation, or if they worsen during menstruation, one possible cause could be endometriosis.

Infertility

As many as 40% of women who have trouble getting pregnant have endometriosis. The exact reason is unclear, but medical experts suspect that inflammation plays a role. The inflammation caused by endometriosis damages the sperm or egg or makes it harder for them to move. Also, endometrial scar tissue might block your fallopian tubes.

Other

Other symptoms of endometriosis include fatigue, nausea, diarrhea, or constipation and bloating.

As noted earlier, these symptoms can be vague and sporadic. The severity of the symptoms is not indicative of the severity of the case. If you experience the symptoms frequently or regularly during your menstrual cycle, you should be examined for endometriosis.

How Do You Test For Endometriosis

Diagnosing endometriosis can be difficult, especially when you have few if any symptoms. You cannot safely self-diagnose it; the symptoms make the condition easy to mistake for other types of health disorders such as irritable bowel syndrome or ovarian cysts.

Diagnosis and subsequent treatment involve a multiple-step process:

Pelvic Exam

The first step in diagnosing endometriosis is a pelvic exam by your gynecologist. Your gynecologist will manually examine your pelvic area for abnormalities.

Ultrasound of Your Pelvic Region

An ultrasound test uses high-frequency sound waves to create images of the inside of your pelvic region. It may be performed by pressing a device called a transducer against your abdomen or inserting it into your vagina.

Magnetic Resonance Imaging (MRI).

An MRI uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. It can give your gynecologist a detailed view of cysts and scar tissue that can help in treatment.

Laparoscopy

The best diagnostic exam for endometriosis is a laparoscopy. It is a surgical procedure that allows a surgeon to view inside your abdomen using a slender viewing instrument called a laparoscope. During a laparoscopy, your surgeon may be able to fully treat endometriosis possibly eliminating the need for another surgery.

Contact Raleigh Gynecology For More Info On Testing For Endometriosis

Endometriosis is a serious health condition that often escapes early diagnosis. It can cause infertility and other health problems. It also may raise your risk of ovarian cancer or another cancer called endometriosis-associated adenocarcinoma.

If you are having any symptoms of endometriosis, it is important to get it diagnosed and treated as soon as possible. Contact the women’s health and reproductive specialists at Raleigh Gynecology and Wellness for more info on how do you test for endometriosis and to schedule an appointment.