By Kathleen Doheny
WebMD Health News
After Lena Dunham, 29, star and producer of HBO’s “Girls,” told fans on Monday she is taking time off to rest due to her endometriosis, many wondered: What is this condition, anyway?
Tamer Seckin, MD, a board-certified obstetrician-gynecologist and co-founder of theEndometriosis Foundation of America, addressed the most commonly asked questions.
WebMD: What is endometriosis?
Seckin: Endometriosis is a disease, a condition. It is a displacement of the internal uterine lining [endometrium] outside the uterus. It is characterized by painful periods with symptoms of heavy bleeding which very often coincide with gastrointestinal symptoms [such as diarrhea] during and around the menstrual period. There can be painful intercourse. It can cause painful bowel movements and appendicitis-like symptoms.
WebMD: How common is it?
Seckin: One of 10 women of reproductive age has it. There are so many cases that are undiagnosed.
WebMD: How bad is the pain?
Seckin: [There can be] severe pain with periods—debilitating, incapacitating pain, killer cramps, and women can be unable to work or go to school. Pain can last more than two or three days, with heavy periods, prolonged periods. There can be leg pain and back pain.
WebMD: What are the health effects?
Seckin: There is loss of quality of life, and reduced fertility and infertility. If you are stuck with pain one week every month, your quality of life is gone. Endometriosis has been linked with an increased risk of ovarian cancer, but the incidence is low.
WebMD: How is endometriosis treated?
Seckin: Medications [for pain] don’t remove the disease. Hormone treatment has side effects. Hormone treatment makes women gain weight. Removal of these lesions [with surgery] leads to the best recovery. (Lesions are areas where the uterine lining is growing outside the uterus.) Surgery requires incredible precision, laparoscopic excision surgery. You remove the lesions and you identify them completely. If you go in and remove 95% of the lesions and leave 5%, the patient’s uterus may be the same and they won’t be helped.
Hysterectomy, or removing a women’s uterus, is indicated when the endometriosis involves the uterus. However, a lot of times [the tissue is growing] outside the uterus.
WebMD: How does it vary in severity?
Seckin: In general the severity of the symptoms does correlate with the degree of the disease but there are exceptions. Particularly in young women, college girls and those in young womanhood, the lesions are early and it could be difficult to identify them. An experienced surgeon who knows how to identify the lesions is crucial.
WebMD: How is it diagnosed?
Seckin: There are stages of diagnosis. The ultimate diagnosis is only made by removing these lesions and putting them under the microscope. Another doctor sees them under the microscope and recognizes the disease. A definitive diagnosis is not limited to just removal but is subject to a pathologist who views the lesions].
WebMD: Is rest advised?
Seckin: Apparently when the pain is so incapacitating, I don’t see any other choice besides rest. Everyone deals with the pain differently.