Simply put, endometriosis is a disorder in which tissue that normally lines the inside of your uterus grows on the outside of your uterus.
It usually affects women in their 20s and 30s, and early diagnosis is critical, particularly in young women hoping to preserve their fertility.So, how do you know if you have it?
Here are a few telltale signs:
- Heavy bleeding or pain during your menstrual cycle
Sure, bleeding and pain during your menstrual cycle are subjective, but there are some guidelines to help you determine if your suspicions are warranted.
The rule of thumb to determine heavy bleeding is more than 80 mL during the week of your cycle. But, of course, who measures it? So, think instead in these terms: If you’re bleeding enough that you have to go to the emergency room for a blood transfusion, if you’ve been diagnosed with anemia and have to take iron supplementation, or if you wear a tampon and pad and are soaking through both every two hours, those are all concerning indicators.
With regard to pain, the lines are a little blurrier, but, for the most part, it has to occur three days before you start bleeding and end when you stop bleeding.
Although there are some exceptions: “Some women with endometriosis can still have pain throughout their entire 28-day cycle, but it mostly occurs while they’re bleeding,” said Dr. Susan Oakley, Director of Pelvic Medicine and Reconstructive Surgery with St. Elizabeth Physicians.
If you’ve tried for more than 12 months to get pregnant and haven’t conceived, endometriosis might be the cause of your infertility.
- A retroverted uterus
Most women with endometriosis have a retroverted uterus or a uterus that’s tilted backward toward the rectum instead of tilted forward toward the bladder.
But Oakley is quick to point out that it’s not at all abnormal to have a retroverted uterus.
“If you have endometriosis, you’re more likely to have a retroverted uterus,” she said, “but it doesn’t work the other way around.”
If you suspect endometriosis, start with your OB-GYN to develop the best management plan. Because the only way to diagnose endometriosis is by taking a sample of it from inside your pelvic area – most often through laparoscopic surgery – most doctors will treat you for endometriosis based on a clinical suspicion.
“It’s important for women to not be scared because even though the diagnosis does require surgery to get a biopsy, they can still be treated before being diagnosed, and that treatment can still be medicine,” Oakley said.
It’s also worth noting that endometriosis is staged, but while advanced stage does correlate with infertility, symptoms do not correlate with stage.
That means that even if your symptoms are mild, you should still consult with a doctor because the disease could be advanced and your fertility could be affected.