Endometriosis & Hysterectomy Surgery

Endometriosis is a gynecological/reproductive disorder that affects more than 176 million women throughout the world and more than 8.5 million women in North America. A leading cause of infertility, chronic pelvic pain, and hysterectomy, endometriosis can significantly impact the lives of women. Given the prevalence of the condition, studies and research throughout the past decades have increased and focus on raising awareness, advocating for early detection and prevention, and discovering new innovative, minimally invasive treatment options. As endometriosis, as well as certain treatment options, are life-changing experiences that have the ability to compromise an individual's well-being in numerous, profound ways, education about the disorder is vital.

What is endometriosis?

Under normal circumstances, the female body naturally sheds the tissue lining the uterus (endometrium) during menstrual periods. With endometriosis, however, these menstrual fluids spread back into the body (retrograde menstruation - the commonly accepted theory) and can become implanted in areas outside of the womb. As hormones fluctuate throughout the menstrual cycle, displaced tissue thickens, menstruates, and sheds. Unlike tissue under normal conditions, the endometrium implanted in areas throughout the uterus has no way of exiting the body, which subsequently causes a number of adverse effects.

When aberrant tissue is unable to exit the body, it can cause tissue irritation, scar tissue, and adhesions, where tissue binds organs together. Internal and abnormal bleeding, degeneration of blood and reproductive tissues, inflammation, and interference with other structures of the pelvic cavity can also occur. As a result, many women experience painful symptoms, bowel or urinary disorders, painful intercourse, and problems with fertility.

There are currently no known definitive causes of endometriosis, although medical studies and research volleys around numerous speculative theories and debatable causes. While retrograde menstruation (the flow of blood and endometrial cells back into the body) is one of the most likely and accepted causes of endometriosis, studies also suggest a number of other potential causes and contributing factors to this disease, including:

  • Genetics and family history
  • Immune dysfunction that inhibits the body's ability to target and destroy displaced tissue
  • Metaplasia, which involves a cell's ability to transform into another type of cell
  • Surgical scar implantation, where surgical procedures such as a hysterectomy or C-section cause endometrial tissue to become implanted in other areas
  • Environmental factors and toxicants

Theories also suggest that women who begin their period at an early age, experience heavy or prolonged menstruation, and/or short monthly cycles may be more likely to develop the disorder. These are all, of course, speculative scientific theories, and no one theory definitively or conclusively explains the development of endometriosis in all patients.

Endometriosis can affect many areas of the female reproductive system, including the ovaries, fallopian tubes, supporting tissues, the outer layer of the uterus, the lining of the pelvic cavity, vagina, cervix, bowel, bladder, and lower intestine. In some cases, although less common, endometriosis may affect other surrounding organs. Contrary to common misconception, all degrees and locations of endometriosis have the capability to cause symptoms and pain. These symptoms also entail far more than painful cramping alone. Characteristic symptoms of endometriosis include:

  • Painful menstruation, rectal pain, and pain during intercourse
  • Gastrointestinal problems, including nausea, bloating, gassiness, cramping, and constipation/diarrhea
  • Chronic or acute pelvic pain
  • Abnormal bleeding, discharge, or clotting
  • Ovarian cysts
  • Urinary problems, including urgency, frequency, and blood in the urine
  • Fatigue, allergies, and other immune-related conditions
  • Infertility, difficulties with conception, and difficulties with pregnancy

Diagnosing Endometriosis 
Treatment for the disease endometriosis has previously been hindered by misinformation, uncertainty, and a general lack of scientific information. Increased awareness, however, has contributed to a rise inaccurate assessment and diagnoses. Women who seek medical attention for the characteristic signs and symptoms of endometriosis face barriers that include poor recognition and understanding of the disease. Additionally, diagnostic technology fails in many respects to accurately diagnose this condition. What is known, however, is that accurate confirmation of the condition requires a surgical biopsy or the sampling of tissue for testing.

Biopsies are typically obtained through a minimally invasive procedure known as laparoscopy, which can be performed in an outpatient setting. A laparoscope, a thin tube-like instrument with a camera attached, allows a doctor to view the abdomen and pelvic cavity and take samples of tissue. Currently, any diagnostic approaches other than laparoscopy are considered uncertain. Diagnostic elusiveness further complicates recognition and treatment of this condition and can cause erroneous diagnoses, which can greatly compromise treatment.

Treatment Options

As endometriosis is poorly recognized and understood, threats of ineffective and untimely treatment remain. As awareness throughout the general public and medical community increases, however, it has been found that symptom awareness, prevention, and early detection are crucial to enabling successful treatment approaches. Furthermore, new breakthroughs in medical science, technology, and information about the disease have contributed to the development of innovative treatment options that provide women with more effective, less painful, and generally less-impacting alternatives to traditional treatment methods.

Hormone therapy, conservative approaches such as pain medications, diet and nutrition, and exercise, as well as various alternative or homeopathic therapies may help to alleviate symptoms. Although medical professionals once focused on the "management" of painful symptoms, which could cause years of discomfort and a decreased quality of life, shifting trends have led to an increased focus on addressing the underlying problem and preventing recurrence.

Hysterectomy, the surgical removal of the uterus, was once the standard for treating women with endometriosis. As with other "hit or miss" surgeries, hysterectomy may not always be necessary. While some situations may make hysterectomy the best choice, other treatment options should always be explored. Today, specialized surgery is known as laparoscopic excision offers women a safer, effective alternative to invasive and life-altering procedures. It works by removing diseased tissue from affected areas while sparing healthy tissues and organs. Laparoscopic excision also results in faster recovery. Ideally, this innovative, minimally invasive approach, as well as other new types of hysterectomy surgeries, should be performed by highly experienced specialist surgeons using a multidisciplinary approach.

Let Us Be Your Comprehensive Resource

As increased awareness and medical exploration expand the horizons for prevention and early diagnosis, effective treatment of endometriosis is gaining unprecedented attention. Hysterectomy.com was created with the intention to educate women and the general public about various reproductive conditions affecting the female population and available treatment options. As awareness and information are essential to one's ability to successfully overcome these difficult experiences, the information, support, and resources we provide can make a profound difference in your ability to understand your specific conditions and options and to make an informed decision about your treatment approach.

Dr. Tamer Seckin is a leading specialist on the topic of hysterectomy and related causes for the procedure, including endometriosis. Co-founder and medical director of the Endometriosis Foundation of America (EndoFound), Dr. Seckin offers his extensive experience and support to women and families throughout the nation who are interested in learning more about endometriosis, hysterectomy, and all available treatment alternatives. By completing a contact form, you can receive specific information from Dr. Seckin regarding any questions or concerns you may have. You can also visit Dr. Seckin's website to learn more about his expertise, advocacy, and efforts to increase awareness about this condition and various procedures.