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Most women experience discomfort during their menstrual cycle. However, if you are experiencing severe pelvic pain, you may be suffering from endometriosis.

The inner lining of the uterus is called the endometrium. It is during a woman’s monthly menstruation that this tissue is shed through the vagina. When a woman has endometriosis, fragments of the uterine lining develop in places outside the uterus. This tissue is very similar to the uterine lining and can attach to the ovaries, fallopian tubes, peritoneum, intestines, vagina, and the outside of the bladder.

Any woman that can menstruate can get endometriosis; women between the ages of twenty-five and forty have the highest incidence.

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Most women do not know they have endometriosis, and they suffer from extreme pelvic pain and cramping. The tissue that has attached itself outside the uterus also responds to a woman’s monthly hormonal cycle. This tissue then bleeds since it may not be able to be shed via the vagina. The surrounding tissue becomes inflamed and can potentially become scar tissue and/or cysts. Endometriosis may affect a women’s ability to become pregnant and can also present as pain with bowel movements or pain during sexual intercourse (dyspareunia). Some women may have no symptoms at all.

The only way to truly confirm if you have endometriosis is to have a surgical procedure called a laparoscopy. During a laparoscopy, a small incision is made in the abdomen so that a physician can insert a scope to look for endometrial tissue implants. These implants are then biopsied to confirm the diagnosis. Once the diagnosis of endometriosis is made, these implants can be surgically removed.

Medical treatment of endometriosis includes birth control pills, hormonal therapy, hysterectomy, anti-inflammatory drugs (NSAIDs), and several prescription medications.

Vaginal dilators may be a helpful tool to help stretch and soften scar tissue. Using vaginal dilators increases blood flow to the pelvic organs and can help strengthen the pelvic floor. When purchasing vaginal dilators, look for progressively sized dilators that are made of silicone and made in the USA.

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For women experiencing pain with intercourse (dyspareunia), there is a wonderful device called the OHNUT, which is a wearable device (worn by the penetrating partner) made of soft “modular rings”. These “rings “are adjustable and control the depth of penetration.

The Endometriosis Foundation of America (Endofound) is a valuable resource and is involved with research and funding. In March of 2022, Endofound worked with the U.S. Senate to pass HR247, which will help fund endometriosis research.

Endometriosis is more common than previously thought. If you or someone you know is suffering from severe menstrual pain, please be proactive and seek medical advice.