Endometriosis is a common condition that affects between 6 – 10% of all women. The condition refers to very small implants of tissue that closely resembles the normal uterine lining, or endometrium, in abnormal locations elsewhere in the body. These implants are stimulated to grow by the circulating hormones normally made during a woman's menstrual cycle.
The most common symptoms of endometriosis are menstrual pain, mid-cycle pain associated with ovulation, and pain with intercourse. Endometriosis can also contribute to infertility; some women have no pain and are only discovered to have endometriosis during a workup for infertility. The degree of endometriosis and the degree of pain often do not correlate.
The condition is first suspected due to a patient's history. Physical exams and sonograms may contribute to our ability to find evidence of diminished organ mobility, pelvic nodules or tenderness, and the presence of related ovarian cysts called endometriomas. The gold standard for definitive diagnosis and simultaneous treatment is laparoscopy, an operative procedure where a small fiber optic scope is placed through the belly button while additional instruments are used to remove the endometriosis implants.
While some women may have complete resolution of their symptoms after laparoscopy, recurrence is common and may require long term management. Dr. Goldman performs both the initial diagnosis of endometriosis as well as the long term therapy of recurrent symptoms; this can include medications, additional surgery, acupuncture and diet. Therapy is always individualized, compassionate, skillful and resourceful.