Endometriosis: The End o’ your World?


By Heath Merkley, MD, FACOG, Mercy Clinic Women’s Health


March is endometriosis awareness month, an opportunity to bring awareness to this disease and how to manage it. Though it can be lifestyle limiting, endometriosis doesn’t have to be the end of your world.




Endometriosis is a condition that affects one in 10 women during their reproductive years. This disorder occurs when cells lining the uterus get outside of the uterus and implant on other organs. These lesions can affect the bladder, bowel, ovaries and fallopian tubes. Some cases have even reported endometriosis in lung tissue, brain tissue and eyes. It most commonly affects women between 18-40 years of age, and there is a genetic predisposition. That simply means if you have a first-degree relative with endometriosis, you are more likely to have the disease.


There are several theories about the development of endometriosis. The most popular is retrograde menstruation, or menstrual fluid backing up through the fallopian tubes and entering the pelvic cavity. This doesn’t account for finding endometriosis in distant locations. Other theories are environmental and embryological. Ultimately, there are probably multiple causes.




This condition typically presents in a woman’s mid-30s with painful periods, infertility and/or pelvic pain. The classic symptom of endometriosis is often pelvic pain, but patients can also experience pain during sexual intercourse, painful bowel movements and sometimes pain with urination. These symptoms can become a significant disruptor in a woman’s life, especially because endometriosis can be a chronic, lifetime disease, lasting until menopause.


Of those who suffer from endometriosis, 51 percent report their disease affects their job. Women may lose a quarter of their work week, or about 11 hours, due to pain. The average patient spends 18 days per year in bed with pain associated from endometriosis. In young patients, this condition causes many young girls to miss school.


With the help and direction of a skilled women’s health provider, endometriosis can be managed and controlled adequately, allowing women to return to normal life.




Endometriosis is typically diagnosed clinically, meaning your doctor can diagnose based on your symptoms. The gold standard of diagnosing this condition remains laparoscopy, meaning visualization of endometriosis and confirmation with a tissue sample tested in pathology.


There are several treatment options for endometriosis. The most basic is oral contraception. Other helpful medications include pills and injections. Some patients may need surgery or a hysterectomy for severe cases.


Endometriosis is also one of the leading causes of infertility. That being said, you can still get pregnant with this condition, and many women do. Some women with endometriosis need help getting pregnant.


This March, if you are concerned about symptoms of painful periods, infertility, pelvic pain, pain during sexual intercourse or bowel pain, call Mercy Clinic Women’s Health to schedule an appointment. My staff and I are prepared to help diagnose and establish a management plan that will allow you to live life more freely.


Merkley is a board-certified OB/GYN at Mercy Clinic Women’s Health in Joplin, located at 100 Mercy Way, Suite 510. To make an appointment, call 417.633.7426, or visit Mercy.net/Merkley.