Endometriosis is a condition in some women that occurs when the cells that normally line the inside of the uterus (endometrial cells) are found in other parts of the body. Women who have endometriosis may experience significant pain, infertility or both.
There are a wide range of symptoms. Usually endometriosis symptoms occur at regular times that are often before, during or after monthly periods.
Symptoms may include:
The Center for Infertility and Reproductive Surgery (CIRS) at Brigham and Women’s Hospital (BWH) is one of the premier infertility and reproductive medicine programs in the country. Our renowned team has one of the highest numbers of physicians in the nation that are certified by the American Board of Obstetrics and Gynecology in reproductive endocrinology and fertility services. Our specialized expertise and access to the latest therapies and technologies in reproductive disorders and reproductive surgery enable us to tailor treatments to meet your individual needs. The Center offers comprehensive diagnostic and treatment services, including:
An experienced gynecologist may suspect endometriosis based on a woman’s symptoms and the findings during a pelvic exam. Currently, the only way to diagnose endometriosis is through laparoscopy – a minor minimally invasive surgical procedure that is done under general anesthesia (while the patient is asleep). Using the laparoscope (which is a type of telescope equipped with a tiny camera on the end), the surgeon can look inside the pelvic cavity and other areas to see if endometrial cells/lesions are present.
There is no cure for endometriosis, nor is there one perfect treatment. Most women will need to try different treatments, which may include medications, behavioral therapy and surgery. Endometriosis treatment requires trial and error to find the best combination for any one person.
If endometriosis is seen at the time of diagnosis, it is removed by cautery (electrical energy), laser (intense light energy) or excision (surgical removal). In general, surgery of this type will lessen pelvic pain associated with endometriosis and will enhance fertility.
Often, non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) are prescribed first. An evaluation at a pain treatment program can often be very helpful for managing pain. Some women find that alternative therapies, such as acupuncture, physical therapy or bio-feedback, also can be helpful.
Other treatment options include hormonal therapies. Birth control pills, which contain estrogen and progestins (progesterone hormone), are usually prescribed first. Combinations of estrogen and progestin also may be prescribed as a patch (an adhesive bandage) or a ring, which is inserted into the vagina. Other options include progestin alone, gonadotropin-releasing hormone agonists (drugs that lower estrogen) or Danazol (a male hormone-like pill).
Many women with endometriosis experience difficulty when trying to get pregnant, but this is not a universal problem among women with endometriosis. Some women will be able to become pregnant without treatment. Since all hormonal treatments prevent pregnancy, medical treatments for endometriosis are not used in women who are attempting to conceive.
Treatment options to improve fertility outcomes include:
The faculty members and researchers at the Brigham and Women’s Hospital Department of Obstetrics and Gynecology are dedicated to doing everything possible to provide women and their families with the most advanced care available anywhere.
As a teaching hospital of Harvard Medical School, we are world-renowned for our expertise in gynecology and pregnancy, and have been a trusted name in women’s health for more than 180 years. Our rich history includes landmark research that has helped guide the care provided to women around the world. Learn more about our research.
Our commitment to patient- and family-focused care has shaped our Center for Women and Newborns at the Mary Horrigan Connors Center for Women’s Health – world-renowned for the quality of our obstetrical and neonatal care and dedicated to the most comprehensive state-of-the-art obstetrical services under one roof. Brigham and Women’s Hospital is the birthing center most women in Massachusetts choose and U.S. News & World Report has repeatedly named Brigham and Women’s Hospital among the top hospitals in the nation in Gynecology.
BWH has long been committed to not only the care of our patients with endometriosis symptoms but also the many other needs that they and their families have. This philosophy of patient- and family-focused care – involving systems and services that emphasize healing in a comfortable, relaxed environment – is a guiding force behind the care we provide.
BWH is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our Inpatient Satisfaction Survey, sent to patients’ to assess their total care experience, helps us to monitor what we are doing well and where we could improve. We pride ourselves in the Quality of Patient Care we provide and how we compare with other hospitals.
The Center for Infertility and Reproductive Surgery’s endometriosis care team is committed to patients and their families. Each patient's diagnosis and treatment plan will be designed and tailored to their needs. Our team of highly skilled doctors, nurses, and other health care professionals work together to deliver the highest quality care to every patient.
If you believe you should have an evaluation of your endometriosis symptoms and would like to schedule an appointment with one of our endometriosis experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form.
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