Letters to the Editor

Know the signs of endometriosis

March is Endometriosis Awareness Month. Endometriosis is a condition too often overlooked given the serious damage it can cause women. Blood is trapped inside the woman’s pelvis during her monthly cycle. It starts accumulating inside the belly, the ovaries, on top of her womb, the surface of the bladder, intestines or tubes, or along the pelvic sidewalls.

The body doesn’t like that. It starts sending immunologic defenses to those areas, causing pain, cramping, and eventually scar tissue that can totally change a woman’s anatomy, and destroy her natural fertility.

No completely specific test exists to diagnose endometriosis with certainty. But there are indicators suggesting one should seek a diagnosis. These include spotting before the period starts, severe pain and cramping during, and after, the period, and pain during intercourse that in certain positions worsens over time. Also, if family members have been diagnosed with endometriosis. When combined with the other symptoms, seek treatment options.

For pain management, minimally invasive outpatient telescopic surgery is a reliable option. Also, hormonal control of estrogen production, a stimulant for endometriosis, can be helpful. Such treatment is FDA approved, effective and doesn’t cause negative side effects. New medications are also available, including a hormone taken orally that allows the pituitary gland to stop stimulating the ovaries.

To conceive, normal, strong ovulation is required, but this worsens the condition. The best option is a quick and definitive diagnosis by laparoscopic surgery, with proper reduction of the disease implants, scar tissue and cysts, followed by aggressive ovulation treatment.

Unfortunately, in some situations, there is just no way around the use of IVF to bypass the pelvic anatomy. This is all the more reason for women to monitor their health and take action when symptoms present themselves.

Juergen Eisermann,

medical director, founder,

IVFMD,

South Miami

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