Your Pain Is Real
You have been told your period pain is "normal." You have been handed ibuprofen and told to use a heating pad. You have missed school, missed work, cancelled plans, and quietly wondered if something is genuinely wrong with you or if you are just being dramatic.
You are not being dramatic.
Endometriosis is a chronic, inflammatory condition where tissue similar to the uterine lining grows in places it should not: on the ovaries, fallopian tubes, the outer surface of the uterus, and in severe cases, the bowel, bladder, and pelvic sidewalls. These misplaced implants respond to your menstrual cycle hormones, causing inflammation, scarring, adhesions, and pain that can range from debilitating to life-altering.
An estimated 1 in 10 women of reproductive age has endometriosis [1]. The average time from symptom onset to diagnosis is 7 to 10 years. That delay is not a medical mystery; it is a systemic failure to take women's pain seriously. At MomDoc, we refuse to participate in that failure.
Beyond "Bad Cramps": The Full Symptom Spectrum
Endometriosis is far more than painful periods. The condition creates deep, chronic inflammation throughout the pelvis that affects multiple organ systems:
- Dysmenorrhea (painful periods): Pain that starts before your period, is not adequately controlled by over-the-counter pain relievers, and progressively worsens over months or years.
- Chronic pelvic pain: Pain that persists throughout the entire cycle, not just during menstruation.
- Deep dyspareunia: Pain during or after sexual intercourse, particularly with deep penetration. This symptom is frequently underreported because patients feel too embarrassed to bring it up.
- Painful bowel movements or urination during menstruation (dyschezia and dysuria).
- Heavy or irregular menstrual bleeding.
- Bloating and gastrointestinal distress ("endo belly"), often misdiagnosed as IBS.
- Fatigue: A pervasive, bone-deep exhaustion that is disproportionate to activity level.
- Infertility: Endometriosis is found in 25% to 50% of women evaluated for infertility [1].
How MomDoc Diagnoses Endometriosis
We approach suspected endometriosis with a systematic, patient-centered workup:
- Detailed symptom history: We use structured questionnaires to capture the full pattern of your pain, including timing, location, severity, and impact on daily life.
- Thorough pelvic examination: Performed to check for tenderness, nodularity, and reduced organ mobility that may suggest adhesions.
- Transvaginal ultrasound: Can identify endometriomas (ovarian "chocolate cysts") and deep infiltrating endometriosis in experienced hands.
- MRI: Ordered when deep infiltrating endometriosis is suspected, particularly involving the bowel or bladder.
- Empirical medical treatment: Current guidelines support initiating hormonal suppression therapy based on clinical suspicion without requiring surgical confirmation first [2].
- Diagnostic laparoscopy: Reserved for patients who do not respond to medical management, need a definitive tissue diagnosis, or require surgical treatment for fertility.
Treatment: A Tailored, Stepwise Approach
There is no single cure for endometriosis, but effective symptom management is absolutely achievable.
Medical Management (First-Line)
- NSAIDs (ibuprofen, naproxen): For mild pain, used in combination with hormonal therapy.
- Combined oral contraceptives: Suppress ovulation and reduce menstrual flow. Can be taken continuously to eliminate periods entirely.
- Progestins (oral, injectable, or IUD): Thin the endometrial lining and suppress implant growth. The hormonal IUD (Mirena) is particularly effective for endo-related pain.
- GnRH agonists/antagonists: For more severe cases. These medications temporarily create a low-estrogen state, shrinking implants. Add-back hormonal therapy prevents bone loss and menopausal symptoms.
Surgical Management
- Laparoscopic excision: The gold standard for surgical treatment. Excision (cutting out) of implants is superior to ablation (burning) for reducing pain recurrence [2].
- Robotic-assisted surgery: MomDoc offers da Vinci robotic surgical capability for complex, deeply infiltrating endometriosis requiring precise dissection.
- Hysterectomy with excision: A last resort for patients with severe disease who have completed childbearing and failed all conservative options.
Myth Busting: "Pregnancy Cures Endometriosis"
This is false. Pregnancy can temporarily suppress endometriosis symptoms due to sustained high progesterone levels, but it does not cure the disease. Symptoms frequently return after delivery and breastfeeding end. Telling a patient in pain to "just get pregnant" is medically inaccurate and dismissive.
The MomDoc Difference
We do not dismiss chronic pelvic pain. We do not tell you to "wait and see." We offer:
- Same-week pain evaluation appointments
- In-house transvaginal ultrasound
- A multidisciplinary approach coordinating with colorectal surgery and urogynecology for complex cases
- Robotic surgical capability for minimally invasive excision
- Long-term follow-up plans because endometriosis is a chronic condition that requires ongoing management
"You have already waited too long for answers. At MomDoc, we start listening on day one."
Take the First Step
If you have been living with pelvic pain that disrupts your life, call MomDoc at 480-821-3601 or book a gynecology appointment online. You deserve a provider who takes your pain as seriously as you do.
This content is for informational purposes only and does not replace professional medical advice. Always consult your MomDoc provider regarding your specific symptoms and treatment plan.