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Women's Health

Painful Sex? Extreme Menstrual Cramps? Pelvic Pain? You May Have Endometriosis

According to the Endometriosis Foundation of America, some 200 million women around the globe have endometriosis. Sadly, it can take up to ten years to get a diagnosis. It doesn’t have to, though.

The disease

Your uterus is lined with tissue called endometrium. During your menstrual cycle, the endometrium thickens, and if you don’t get pregnant, it sheds during your menstrual period. Your endometrium is where the embryo implants.

When you have endometriosis, your endometrium grows outside of your uterus. It can be on the outside of your uterus, on your fallopian tubes, ovaries — basically anywhere in your pelvic cavity, or in rare cases, it can involve your intestines, appendix, or other organs.

The migrated endometrium still behaves as it would inside your uterus, thickening and attempting to bleed during your menstrual period. Because there’s nowhere for the blood to go, you can experience inflammation, irritation, and eventually develop adhesions, scar tissue, cysts, and other complications.

Causes and risk factors

No one knows what causes endometriosis, but there are some theories, and there are some risk factors associated with the disease. Some of the possible theories include:

  • Retrograde menstruation, where menstrual blood flows up into your fallopian tubes rather than out of your body
  • Transformation of certain cells, which is when hormones trigger certain types of cells to transform into endometrial cells
  • Endometrial cell transport, where your lymphatic system transports endometrial cells to other parts of your body
  • Immune system disorder, which is when your immune system malfunctions and fails to recognize endometrial tissue is growing where it shouldn’t be

Some of the risk factors that are associated with endometriosis include:

  • Not giving birth
  • Starting menstruation at an earlier-than-average age
  • Not experiencing menopause until a later-than-average age
  • Having shorter than normal menstrual cycles
  • Having a low body mass index
  • A family history of endometriosis
  • Certain medical conditions that prevent normal flow of menstrual blood
  • Abnormalities in your reproductive tract


There’s not a lab test for endometriosis, so Dr. Neyman can’t simply draw your blood or take a sample of your urine to determine whether or not you have it.

In fact, the skill and experience of your physician is often the key to getting a diagnosis. It takes an average of 10 years from the first sign of symptoms to diagnosis in the United States, which is why Dr. Neyman’s expertise is so critical.

Imaging, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans can be helpful in conjunction with a pelvic exam; these and a detailed medical history can all be used to confirm that you have endometriosis.

In order to know for sure, Dr. Neyman performs a diagnostic laparoscopy, which is a type of minimally invasive surgery, to obtain biopsy specimens.


Endometriosis is a complex disease, and the most appropriate treatment depends on numerous factors. Dr. Neyman may suggest surgery to excise, or remove, lesions, or even hysterectomy. She may also recommend managing your symptoms rather than treating the disease itself.

Some common methods of controlling endometriosis symptoms include:

  • Hormonal birth control
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Hormone therapy
  • Changes in nutrition
  • Complementary therapies, such as acupuncture

If you have reason to suspect you may have endometriosis, book an appointment online or by phone with Dr. Neyman. It’s important to get a personal evaluation because everyone is different and endometriosis can vary so much from person-to-person.

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