The lining inside of the uterus is called the endometrium. Sometimes cells from it are found outside of the uterus. This is called endometriosis. Women in their 20s, 30s, and 40s are most likely to notice problems. Teens and women past menopause can have them, too.

• Pain before and during menstrual periods. The pain is usually worse than normal menstrual cramps.

• Pain during or after sex.

• Pain when you pass urine.

• Lower back pain. Painful bowel movements. Loose stools with menstrual periods.

• The pelvis feels sore or tender.

• Spotting of blood before a monthly period starts.

• Menstrual periods are longer or heavier than normal.

• Infertility.

Some females have no pain.

The exact cause is not known. It could be that some of the lining of the uterus moves backwards through the fallopian tubes into the abdominal cavity. It then attaches and grows in these places. It could also be due to problems with the immune system and/or hormones. The condition may also run in families.

Surgery

• One type uses a very small, lighted tube to remove or destroy areas of endometriosis. This reduces pain. It allows pregnancy to occur in some women.

• Another type removes the ovaries. The fallopian tubes and uterus can also be removed. This gets rid of the pain. A woman can’t get pregnant after this is done.

Medication Therapy Options

• Pain medicines. These include ibuprofen and naproxen sodium.

• Birth control pills. These are given in a certain way to stop ovulation and menstruation for a set amount of time. They are used for very mild cases.

• Anti-estrogens. These cause a woman’s body to make less estrogen.

• Progesterone. This destroys endometrial cells.

• Drugs called GnRH agonists. These stop the body from making estrogen. This causes a temporary “menopause.”

Do you have a lot of pain at any of these times?

• During sex.

• With monthly menstrual periods and this has gotten worse over time.

• When you pass urine.

Do you have any of these problems?

• Spotting of blood before your period starts.

• Menstrual periods are heavier or last longer than normal.

Endometriosis needs medical treatment. What can you do?

• Get regular exercise.

• Eat a diet high in nutrients and low in fat, especially saturated fat. This is mostly found in coconut and palm oils, animal sources of fat, and hydrogenated vegetable fats.

• Take an over-the-counter medicine for pain. Ask your doctor which one(s) he or she prefers you take.