A patient talks to their OB-GYN at their recent appointment on endometriosis.
Your OB-GYN can determine if your pelvic pain is attributed to endometriosis, which is a treatable condition. (For Spectrum Health Beat)

One of the most common gynecological issues women experience is pelvic pain and pain during intercourse.

There may be several possible causes for these symptoms, including endometriosis, said James Patenge, DO, an OB-GYN with Spectrum Health.

The good news: Treatments are available.

Endometriosis occurs when tissue that normally lines the inside of the uterus grows outside the uterus, Dr. Patenge explained.

It’s unknown why this happens.

“The abnormal tissue growing outside the uterus can grow on ovaries, Fallopian tubes, intestines, bladder and on the pelvic wall,” Dr. Patenge said. “The tissue can cause adhesions or scar tissue.”

These adhesions can cause organs to stick together, causing more pain, he said. It can even lead to infertility.

Endometriosis symptoms

During normal menstruation, the buildup of endometrial tissue inside the uterus thickens, breaks down and bleeds out from the body. This is commonly referred to as a period, Dr. Patenge said.

“This occurs from the fluctuation of hormones from the ovaries,” he said.

Abnormal endometrial tissue outside the uterus reacts the same way—it thickens and breaks down, but has no way to exit the body, he said.

“It becomes trapped in the body and becomes what is referred to as endometriosis implants.”

Common symptoms of endometriosis include pelvic pain, cramping, painful periods, pain during sexual intercourse, pain during urination, painful bowel movements, diarrhea and constipation.

“Many women experience the pain most often during menstrual cycles, but the pain can start several days prior to the start of menstruation and last several days into menstruation,” Dr. Patenge said.

“Interestingly, the amount of endometriosis tissue does not correlate with the amount of pain.”

While some women may have a large amount of abnormal tissue with little pain, others may have a small amount of abnormal endometrial tissue and severe pain, according to Dr. Patenge.

“Some women who have a lot of abnormal endometrial tissue (implants) are completely unaware because they suffer no pain at all from their endometriosis,” he said.

During pregnancy, menopause or while breastfeeding, the ovaries are not fluctuating with the same levels of the estrogen hormone.

“So the endometrial pain tends to go away and is less likely to be noticed during those times,” Dr. Patenge said.

Finding answers

Treatments for endometriosis vary.

The condition will likely resolve on its own during menopause, or with surgical removal of the ovaries.

Once the condition is diagnosed by your women’s health provider, there are also medications and surgical procedures to control the endometriosis.

“I treat endometriosis in women every day and have a variety of solutions to meet every women’s situation and needs,” Dr. Patenge said. “If you suffer from pelvic pain, know that you are not alone.

“You don’t have to live in pain.”