For people living with endometriosis, the cramping and pain that come with menstrual cycles can be debilitating.
“In the past, if people had very painful periods, they were told, ‘that’s just how it is,’” says Tidelands Health OB/GYN Dr. Andrea Richmond-Mart, who provides care at the Azalea Lakes, Murrells Inlet and Georgetown locations of Tidelands Health OB/GYN. “But now we know that level of pain is an indication that there’s probably something else going on.”

That “something else” can be endometriosis, a condition that causes uterine tissue known as endometrium to grow outside the uterus. The tissue can attach to nearby organs, such as the large intestine, or along the outside of the uterus.

The wayward tissue can cause serious problems because, despite being outside the uterus, it still responds to the hormones that prompt the uterine lining to thicken and slough off during a person’s menstrual cycle. However, the misplaced tissue can’t be flushed out of the body and instead remains in place where it can cause scarring, problems with bowel movements, pain during sex, difficulty conceiving children and other symptoms.

There is no single test to indicate a person has endometriosis. Diagnosis is primarily about evaluating symptoms – pain being most common – and eliminating other potential health issues as the cause, says Dr. Richmond-Mart.
The precise cause of endometriosis remains unclear. Researchers believe that in some cases endometriosis may occur when endometrial cells make their way up the fallopian tubes and escape into the body cavity.
Endometriosis likely also has a genetic component. If a patient’s mother or aunt experienced endometriosis, there’s an increased likelihood the patient will experience the condition.
“What we know about endometriosis is that it’s recurrent and progressive,” Dr. Richmond-Mart says. “It’s not life threatening, but there is a lot of inflammation. It can cause scarring that can make it difficult to conceive children.”

Initially, treatment typically involves non-invasive approaches such as prescription anti-inflammatory medications, oral contraceptives or a hormonal IUD to treat pelvic pain and heavy menstrual bleeding.
The most direct treatment is surgery to remove the misplaced tissue. The procedure is typically completed laparoscopically, a minimally invasive approach that requires the surgeon to make small incisions in the abdomen to remove the lesions or burn them. At Tidelands Health, our region’s leading health care provider, women have the option to benefit from robotic-assisted surgery for endometriosis.
The approach allows surgeons to perform surgery through small incisions in the body using robotic arms that are fully controlled by the surgeon. It can result in decreased blood loss, faster recoveries, smaller scars and less post-operative pain compared to traditional approaches.

For women who are finished having children but not yet entered menopause, a hysterectomy can help reduce pain from the condition, Dr. Richmond-Mart says. If the ovaries are left in place, the pain people experience may persist, so often providers will discuss removing at least one ovary depending on the severity of the condition and the age of the patient.
Regardless of the treatment approach, patients who have a history of painful menstrual cycles have better options than simply living with the pain, says Dr. Richmond-Mart.
“It’s coming more to the forefront of gynecological health and becoming talked about more,” she says.
If you are struggling with painful periods or have other questions or concerns related to your health, be sure to speak to your OB/GYN or other qualified health care provider.