Scientists aren’t sure exactly what causes endometriosis, but they do know that genetics plays a leading role in risk (if your mom or sister has it, your chances increase sixfold); exposure to pollutants such as dioxin, a chemical used in pesticides and bleached paper, might also be a prime risk factor. For now, the only way to score a definitive diagnosis is through surgery.
“To be sure, we have to physically see this tissue living where it doesn’t belong,” explains ob-gyn Shari Brasner, M.D., of the Mount Sinai School of Medicine in New York City. This procedure involves general anesthesia and a camera exploring the inner abdomen and pelvis. If a physician finds any wayward tissue, it can often be removed right then, though it can grow back. The good news: Less-invasive diagnostic procedures (including in-office biopsies and blood tests to measure inflammation levels) should be available within three to five years, says Falcone.
Of course, after getting the diagnosis, you still have to live with the condition, which can come and go or persist for as long as you menstruate. Birth control can decrease the pain and bleeding, and hormone-manipulating drugs such as danazol and Lupron can shrink the growths by “turning off” the ovaries. (Similarly, “pregnancy will keep endometrial tissue quiet because your hormones aren’t cycling,” says Brasner.) Scientists are now studying how anti-progesterone and breast-cancer drugs may help.
If Rx medicines don’t yield relief, alternative treatments like acupuncture may ease pain. And if nothing else works, more surgery may be in order. But the crucial thing is for each endometriosis patient to receive a tailored health plan that lets her move past the pain and get on with her life.