Back and pelvic pain? It could be endometriosis.

It causes pain and swelling in the lower back, pelvis and stomach; pain before and during your monthly period; and pain during or after intercourse. It can regularly lead to unusual bleeding, diarrhea and nausea. It can even make it difficult to get pregnant.

It’s endometriosis, and if you are one of the 6.5 million people in the U.S. who have it, you know how challenging a medical issue it can be.

According to the U.S. Department of Health and Human Services, endometriosis is a common problem that affects close to 11% of women ages 15 to 44. It occurs when tissue that normally grows inside the uterus instead grows outside of it, usually on the ovaries, fallopian tubes and the tissues surrounding the uterus.

The extra tissue can cause problems in the bladder and intestines, and block the fallopian tubes. It often causes swelling and can lead to the formation of scar tissue and adhesions, binding organs together and leading to infertility.

“Unfortunately, endometriosis is a long-term condition,” says Dr. Tina Ziainia, an OBGYN with Sharp Rees-Stealy Medical Group, who delivers babies at Sharp Mary Birch Hospital for Women & Newborns. “People will have symptoms off and on until they reach menopause if it is not treated. So it is imperative that they find a way to manage their endometriosis to ensure their quality of life is not affected.”

Evidence of endometriosis
The primary symptom of endometriosis is pain. Many with endometriosis experience extremely painful menstrual cramps as well as pain:

• In the lower back and pelvis

• During or after sex

• When urinating or having a bowel movement

Endometriosis can also cause bleeding between menstrual periods as well as gastrointestinal problems, including diarrhea, constipation, bloating and nausea. One of the most troubling conditions related to endometriosis is infertility.

“Some people do not have any symptoms, but are experiencing infertility,” Dr. Ziainia says. “Through their workup, when trying to determine why they have been unable to get pregnant thus far, we find endometriosis.”

Risk factors to recognize
According to Dr. Ziainia, anyone who has menstrual periods can get endometriosis. While genetics are most likely the primary cause, menstrual problems and the hormone estrogen also play a role. Immune system disorders also may support the growth of the extra tissue outside the uterus.

Those at greater risk for endometriosis include women who have:

• A family history of endometriosis

• Never been pregnant

• Long menstrual periods (over seven days)

• Short menstrual cycles (less than 27 days)

Methods to manage endometriosis
While there isn’t a cure for endometriosis, there are ways to manage pain, infertility and other endometriosis-related issues.

“Once endometriosis is diagnosed, we try to manage it medically with anti-inflammatory drugs, birth control pills and GnRH agonists — a type of medication that affects the ovaries’ ability to make sex hormones — to alleviate your symptoms,” Dr. Ziainia says. “Sometimes, surgery is necessary if the endometrial tissue causes large cysts on the ovaries. Those who have completed childbearing and do not find relief with medical management may require a hysterectomy, but this should only be considered if all other options have been exhausted.”
Talk to your doctor if you are experiencing symptoms of endometriosis. Together, you can determine the best way to manage your symptoms and improve your chance of getting pregnant if infertility is a concern.