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3 of 3 Premium Clicks used this month SUBSCRIBE Print + Online Subscriber Activation | Register x Forgot Password | Need an Account? subscribe | newsletter | deals Home News Latest Stories Taste of Ashland starts today Talking trains in Talent Independent Media Week starts Sunday Schneider Children's Center set to close Annual Science of Wine fundraiser coming to Ashland Springs Hotel Education Schneider Children's Center set to close Ashland School District seeks volunteers for Educators' Appreciation Luncheon Planning meeting set Wednesday for farewell party Ashland Middle School to perform "Shrek Jr." musical Earth Day at Bellview Elementary School garden Environment Students at Walker Elementary School in Ashland get hands dirty for Earth Day Ashland Fire & Rescue Alarm Box: There are good fires and there are bad fires Lots to celebrate at SOU Arbor Day rites Business Ride & Drive: 2015 Nissan Frontier Taqueria Picaro takes over Tabu space Lithia Motors reports second-best quarter ever Owner of Mix and Amuse to bring Flip burger joint to Ashland Ride & Drive: 2015.5 Volvo V60 Cross Country Politics and elections Arthur I. 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Herb Rothschild Jr.: 'Right to rest' misguided ... Annual Science of Wine fundraiser coming to Ashland Springs Hotel ... Bill under debate in Oregon would limit livestock antibiotics ... Herb Rothschild Jr.: 'Right to rest' misguided ... Annual Science of Wine fundraiser coming to Ashland Springs Hotel ... Dr. Jeff Hersh: Could severe cramping mean endometriosis? By Dr. Jeff Hersh Wicked Local DailyTidings.com By Dr. Jeff Hersh Wicked Local Posted Apr. 23, 2015 @ 8:46 am By Dr. Jeff Hersh Wicked Local Posted Apr. 23, 2015 @ 8:46 am » Social News p bs:newslist StartDate="20121121" EndDate="p bs:datecalc Months="3"" DateSort="1" UseObjects="1" ObjectClass="81" Taxonomywords="2324,665" ExactTaxonomyMatch="1" Image="1" Count="4" --> Q: My husband and I have been unsuccessful trying to get pregnant for almost two years. Could this be related to my severe menstrual cramps? A: Yes, that is possible; you should see your health-care provider to discuss the possibility that you have endometriosis. Endometrial tissue normally lines a woman’s uterus. Endometriosis is the presence of functional endometrial tissue in sites outside the uterus (called ectopic tissue), usually involving the ovaries, the area behind and/or the ligaments that support the uterus, the colon, the abdominal cavity or the bladder, but it can be located almost anywhere in the body (it has been diagnosed in the lungs and even the arms and legs). There are many theories to how this happens. Some researchers think that endometrial tissue that sheds during a woman’s menstrual cycle may migrate up into her abdomen (this is called retrograde menstruation and is very common) and then seed ectopic locations. Other theories include the spread of endometrial tissue via the lymphatic system or the blood, an immune system issue or even a woman being born with some ectopic embryonic cells. This functional ectopic endometrial tissue responds to hormone stimulation just like the normal tissue inside a woman’s uterus. Therefore it thickens as a woman goes through her menstrual cycle and then sloughs off and bleeds (like the normal tissue causing a woman’s periods). This can cause inflammation and irritation to the structures where the ectopic endometrial tissue resides, causing the symptoms of endometriosis and over time possibly leading to scarring. Up to one-third of women with endometriosis have minor or no pain (or they simply attribute their pain to menstrual cramps); the majority experience dull, aching pain which typically cycles with their menstruation and is associated with the area of ectopic tissue, most commonly pelvic pain although pain with intercourse, urination, bowel movements or other painful symptoms may also occur. The intensity of the pain does not seem to correlate with the amount of ectopic tissue as much as it does with the location and depth of the affected areas. Heavy menstrual bleeding and/or infertility from it are also common. About 10 percent of women (maybe more) have endometriosis to some extent. It is most common in the 25- to 44-year-old age group, but can occur in adolescence and even post-menopausally. Endometriosis is one of the most common causes of infertility, found in 25 to 50 percent of women evaluated for infertility. It most likely contributes to infertility by causing pelvic adhesions, scarring or blockage that alters the fallopian tubes’ ability to capture an egg. Risk factors for developing endometriosis include early onset of menstruation, late onset of menopause, longer cycle lengths and years of menstruation uninterrupted by pregnancy. There is a genetic link; first-degree relatives of someone with endometriosis have a 10-fold increased risk. Oral contraceptives appear to reduce the risk. There are no blood or imaging tests that can definitively diagnose endometriosis, although they may be ordered to look for other conditions (ultrasound often is the first imaging test used to diagnose abnormalities in the pelvis). When endometriosis is suspected, treatment may be initiated based on the history and physical exam; if a definitive diagnosis is needed, a laparoscopy (a minimally invasive surgical procedure to look directly into the abdomen) may be indicated. Since endometriosis is related to the response of ectopic endometrial tissue to a woman’s menstrual cycle, it is not surprising that the treatment, in addition to pain medication as needed, is usually hormonal therapy to suppress the effect of the cyclical hormonal changes. Women with painful symptoms from endometriosis have a 25 to 50 percent chance of their symptoms progressing, about a 25 percent chance of spontaneously improving and about a 35 percent chance of their symptoms remaining stable. Women with endometriosis not responding adequately to medication may require surgical intervention to remove the ectopic tissue and to correct any anatomic distortions. Women who wish to get pregnant should consult a specialist to discuss what approach may be best for them, as well as other options for becoming pregnant. Even after successful removal, endometriosis recurs at a rate of 10 to 20 percent per year, so close followup is necessary. In severe cases that do not respond to ablation in a woman who does not wish to have more children, a hysterectomy with removal of both ovaries may be considered. So if you are having severe abdominal pain that seems to cycle with your menstruation and/or difficulty getting pregnant, you should see your health care provider for further evaluation. Effective treatment options do exist for endometriosis. Jeff Hersh, Ph.D., M.D., can be reached at [email protected]. By Dr. Jeff Hersh Wicked Local DailyTidings.com By Dr. Jeff Hersh Wicked Local Posted Apr. 23, 2015 @ 8:46 am » Comment or view comments /* $( document ).ready(function() { // Jquery mobile is trying to style the button and leaving a blank gry button on top of a white button $("#viafouracoms .vf-comment-controls li.vf-right").html(' Submit '); });*/ » STAY INFORMED Email NewsLetter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. calendar Connect with DailyTidings.com Facebook Twitter RSS Back to top Reader Services Reader Services home Subscriptions Subscriber controls Contact us Submissions Photos Events Letters to the editor Corrections Alerts Email alerts RSS feeds Text Alerts Advertise Media Kit Home Products and services Ad rates Advertising contacts Mail Tribune Daily Tidings The Nickel Shop Our Valley Blogs Stay Informed Email newsletter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. 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