Eliana Has Endometriosis

Endometriosis can be incredibly painful — physically and emotionally — and can lead to infertility. But there are treatments that can preserve your ability to have children.

Medically reviewed by Mary Jane Minkin, M.D.

Transcript

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Doctor’s (woman) office - A Latina servicewoman (18-35) is in the office with an OB-GYN. Eliana is in uniform.	Doctor: Hi, Eliana. I’m glad to see you again. Are you still having heavy bleeding and intense pain during your period? Eliana: Yes, it’s still really bad. Sometimes it hurts so much I can barely walk and it makes me exhausted and anxious. Doctor: I’m sorry it’s not getting any better. The results from the tests we did last time came back. Your endoscopy ruled out GI issues and your ultrasound ruled out ovarian cysts, which leads me to suspect that you have endometriosis.
Symptoms include Intense menstrual cramps Pain during pooping Pain during sex Abdominal pain during or in between periods Back pain during or in between periods Heavy menstrual bleeding Bloating Nausea Fatigue Depression Anxiety Infertility
	Eliana: Oh, I’ve heard of that before but I don’t know exactly what it is. Doctor: It’s when tissue similar to the tissue that lines your uterus grows on other parts of your body. They’re called lesions. This fits with a lot of your symptoms and it could also explain why you’ve had trouble getting pregnant. Eliana: If I do have it, can it be treated?
Possible treatments for endometriosis Birth control pills Gonadotropin-releasing hormone (GnRH) medicines Danazol (hormonal medicine) Laparoscopy Hysterectomy	Doctor: There are a few options. Birth control pills, hormonal medicines or a hysterectomy to remove the uterus are common treatments — but those aren’t good for someone who wants to get pregnant. Eilana: So does that mean I have to wait to treat it or give up on getting pregnant?
Getting relief from endometriosis NSAIDS like Advil, Motrin, Aleve Acupuncture Pelvic floor therapy Cognitive behavioral therapy Stress management Exercising Healthy sleep Eating healthy	Doctor: No, not at all. There are some things you can do to get some relief from the pain that won’t affect your fertility. You can try over-the-counter painkillers, like Advil or Aleve, or a prescription medicine that helps suppress the endometriosis and control pain. Acupuncture, cognitive behavioral therapy, eating healthy, exercising regularly and getting enough sleep may also help, too. Eliana: I’ll definitely try those things. Is there anything else we can do? Doctor: Another option is a laparoscopy. That means we’d look inside your uterus with a camera, called a laparoscope. It’s the only way to tell for sure if you do have endometriosis. And, if you do, we can also take out any lesions we find while we’re in there. Eliana: I would like to know for sure if I have endometriosis, but will the laparoscopy hurt my chances of getting pregnant? Doc: No — the procedure might actually help you get pregnant naturally. Eliana: Ok … since I definitely don’t want the birth control pills or a hysterectomy, let’s try the laparoscopy. Doctor: That sounds like a good idea to me. Eliana: Thank you for explaining all my options.
A year later … Eliana is in the hospital being handed a baby by her OB-GYN.	Doctor: Congratulations! It’s a girl! Eliana: Thanks, it’s been a long road — but it feels so good to finally be here.