Endometriosis Specialist

What is endometriosis?

Endometriosis is a painful, potentially debilitating condition that causes the lining of your uterus (endometrium) to grow outside your uterus. The endometrial tissue can grow on your ovaries, fallopian tubes, and pelvic lining as well as the outer wall of your uterus. It can even grow in areas outside of the pelvis, such as the diaphragm, belly button, or lungs.

The endometrium that grows outside your uterus continues to function like it normally would inside your uterus. The tissue thickens, breaks down, and bleeds with your monthly menstrual cycle. However, this tissue has no way to leave your body, so it becomes trapped and may cause pain, inflammation and scar tissue.

What are the symptoms of endometriosis?

Pelvic pain is the primary complaint of women with endometriosis. While cramping is normal during your period, endometriosis can create severe menstrual pain that goes beyond what most women experience.

Other common symptoms of endometriosis include:

•Severe period cramps

•Painful sex

•Problems getting pregnant

•Excessive bleeding or bleeding between periods

•Bladder pressure or pain, frequent urination

Bowel symptoms such as constipation, diarrhea, or pain with bowel movements

Who is at risk for endometriosis?

Endometriosis is a common women’s health problem, affecting 1 in 10 women. 

Risk factors for developing endometriosis include:

•Family history of endometriosis

•Starting your period at an early age

•Menstrual cycles shorter than 27 days

•Low body mass index

•Never giving birth

•Alcohol consumption

How does a gynecologist treat endometriosis?

First, your doctor or physician assistant at Gynecology Specialists evaluates your symptoms during a physical exam. Depending on the severity of your condition, they may recommend various treatments, including medications, physical therapy, or surgery.  Laparoscopic surgery is required to make a definite diagnosis of endometriosis, though your provider may suspect endometriosis based on your symptoms, and first try medical or lifestyle modification options to help before proceeding with surgery. 

Hormonal medicines are one option for managing your endometriosis. These include:

•Birth control pills

•IUD

Medications to temporarily suppress your ovaries such as Lupron or Orilissa

If your symptoms don’t improve with medications, or you wish to know for certain if you have endometriosis, Dr. Lee and Dr. Tang may recommend surgery. Drs. Lee and Tang are some of the most experienced laparoscopic surgeons in the Philadelphia area, and perform hundreds of laparoscopic surgeries for endometriosis every year. 

Surgical options include a laparoscopy (as mentioned above) and removal of endometrial implants. Other surgical options include hysterectomy to remove the uterus if a woman is also having irregular bleeding or other causes of pain and bleeding such as fibroids or adenomyosis (endometriosis of the muscle of the uterus itself) and is not interested in becoming pregnant in the future, and possible removal of the ovaries, depending on the patient’s age, prior surgeries, severity of endometriosis, and family history of ovarian cancer. At Gynecology Specialists, a surgical consult appointment can be made with one of our surgeons to discuss the risks and benefits of all options in more detail. The decision about what type of surgery or aggressiveness of therapy is always up to the patient herself. 

For other sources of chronic pelvic pain, other treatment options to consider may include pelvic floor physical therapy, antidepressant medications, and multi-disciplinary care with other specialists such as GI doctors, general or colorectal surgeons, urologists, mental health professionals, and your primary care doctor.  At Gynecology Specialists of Philadelphia, we believe in a team approach to management of chronic pelvic pain and endometriosis, and will help arrange appointments with other specialists as necessary. 

The decision about whether treatment is needed, and what type of treatments to choose, are different for every woman. We will discuss all of your options with you, and come to a decision about treatment based upon your personal situation and preferences.

If you’re experiencing symptoms of endometriosis, call or click online to book an appointment with Gynecology Specialists today. If you are coming from outside of the Philadelphia area for a consult with Dr. Tang, we request that you submit any records from your prior endometriosis care (operative reports, pathology reports, imaging studies) for review before we schedule an appointment, so that we can determine if you will also need to see another specialist such as a colorectal surgeon for consultation when you come to Philadelphia.