Patient: I think I may have endometriosis due to some crippling uti issues (that aren’t actually uti’s) that seems to happen especailly right before and during my period, I also have pain urinating especially during my period, I get diarreah and constipation and a sharp pain in my lower left side. I also get very nausea. I talked to a doctor today (one I just met) and she said that the only way to test for endo is to actually undergo surgery and the only options for treatment is to force yourself into menopause with a pill. I am only 27 so obviously would not do that. Especially if there is no way to diagnose me. My question was if there are any other ways doctors can find out if endometriosis is there and if there are any other less drastic treatment options. (I’ve looked at some basic online infomation.) I would also like to know if progesterone would help this? I have heard that it can help he symptoms and I know you can get cream over the counter. I don’t have insurance and don’t want to pay thousands of dollars if it is true that there really isn’t anything they can do anyways (besides put me into menopause).
Symptoms: Uti symptoms but no uti present. (Sometimes Uti present but less often than when there is not) has lasted for about 7 years, about 5 days before my period I am usually convinced I have a horrible horrible UTI (I have gotten UTi’s often before so I know the feeling) I also get Diarrhea right around the same time (The diarrhea USUALLY occurs after the “fake uti pain” starts. I also feel very Nauseous & shakey. Other small things that I can’t think of right now but the last thing I feel is important is a sharp pain in my lower left stomach. This pain causes my stomach to protrude out and I cannot hold my stomach in as normal (Not as in forcing it in, more like it’s bloated out during this pain and if i try to pull it in like it usually is I feel intense pain.) I also cannot stand full up when this pain occurs and sometimes have to lay flat on the ground until it subsides. I have been to the doctor for these but they have never shown concern but I have been dealing with this for 6 years.
Doctor: Thank you for your question. Endometriosis is a painful condition in which tissue that normally lines the uterus (endome trium) implants in other areas of the pelvis and proliferates. Common areas of implantation include outside the uterus, the ovaries, bladder, posterior cul-du-sac, and broad ligament, to name a few. The most common symptom patients complain of who have endometriosis is pelvic pain which can range in severity. Changes in menstrual bleeding, pain during menstruation, lower back pain, pain during urination and defecation can all be associated with endometriosis as well. The main method for diagnosing endometriosis is by a surgerical procedure called a laporoscopy. This procedure involves inserting a camera through a small incision in abdomen to visualize the pelvic cavity. Samples can be taken of possible ectopic endometrial tissue for analysis to confirm the diagnosis. Prior to this procedure, an ultrasound or MRI can be performed, but they are not as accurate a diagnostic as the laporoscopy.Treatment for endometriosis can involve removing ectopic endometrial tissue to complete histerectomy. Given your age, this may not be the first approach and medical management should be given a try. Several types of medications can assist in treating the symptoms of endometriosis such as combination oral contraceptive medications, medications that suppress the production of gonadotrophins (hormones that elicit the release of sex hormones from the ovaries), or medications that initiate the release of progesterone.Before proceeding with treatment, you must be definitively diagnosed with endometriosis. Once this is confirmed, the best treatment will be designed for you, while keeping in mind your concerns about not wanting a hysterectomy or becoming permanently infertile. Please follow up with your gynaecologist.Thank you for consulting AskTheDoctor.com with your medical question.