Austin doctor speaks on endometriosis, how to treat the condition

AUSTIN, Texas - March is Endometriosis Awareness Month.

It's often a painful and debilitating condition that can lead to infertility, and federal health officials with the Office on Women's Health say it may affect more than 11% or more than 6.5 million American women between the ages of 15 and 44. 

Dr. Meena Aserlind, OB-GYN at St. David's Women's Center of Texas, joined FOX 7 Austin's Rebecca Thomas to discuss.

Rebecca Thomas: Dr. Dr. Meena Aserlind, for those who are not aware, what is endometriosis?

Dr. Meena Aserlind: Endometreosis is the lining inside the uterus. That's called the endometrium. That part that comes off every single month with your cycle. That tissue that's inside the uterus can actually implant into the pelvis and can create a lot of pain and discomfort when you have your period. 

Rebecca Thomas: So what are some of the more common symptoms that women should be aware of and then often come in seeking treatment for? 

Dr. Meena Aserlind: This is the most common complaint that we get people coming in for is just having pretty severe pain during their cycles. Some people will start with severe pain during their cycle, and then it progresses to pain even outside their cycle. But almost always, endometriosis starts with just severe pain during the cycle itself, with generally some heavy bleeding and lots of cramping and sharp pain. 

Rebecca Thomas: Do we know what causes endometriosis? Is a woman more at risk or certain women more at risk? Is there any way to prevent it? 

Dr. Meena Aserlind: So it's hard to say exactly where it comes from. There are three theories on where endometriosis comes from most. I would say the common theory that people use, I feel like about 80% is retrograde menstruation, which is just that during your cycle, a little bit of blood goes out through the tubes. And this happens in women in general. So they're not really sure why some women, that tissue that comes out through the tubes actually implants inside the belly. In some women it doesn't. There's not really good information about that. What they do know is that there are some risk factors, including a genetic predisposition to it. So some women, if you see it in families, it's not necessarily mom to daughter, but if you see it in families in general, you do have a higher risk for it. Interestingly enough, tall, thin women tend to be a little bit more at risk for endometriosis. You'll see it in people a lot of times with infertility, if you come in with complaints of infertility. About 38% of women with infertility also have issues with endometrium. This so really not well known where it comes from and how to prevent it, how to cause it. We just know that some women do tend to have those implants that embed and create pain, rather than just sit there and go away on their own. 

Rebecca Thomas: So how do you go about diagnosing the condition? 

Dr. Meena Aserlind: Diagnosis is sometimes difficult. So, usually, people come in with complaints of pain. And the only way to truly diagnose endometriosis is to put a camera inside the belly. So that's what we call a diagnostic laparoscopy. So a camera in the belly to take a look around and actually look for endometriosis implants. Those implants generally have a very wide range of how they can look anywhere, from small little bubbles that are clear in very young women to powder burn kind of looks almost like cigarette burns inside of the belly. Sometimes we'll just see it in a lot of scar tissue holding uterus and fallopian tube and ovaries together. And sometimes it can be missed when we go in, especially in younger women, because it doesn't show the same way. It can be very clear sometimes we miss the diagnosis early on and don't see it until later. But diagnosis in general requires that we have a tissue sample of it. So we have to go in the belly and actually take a sample of the implant and send it off to pathology to fully diagnose it.

Rebecca Thomas: If you are diagnosed, how do you treat endometriosis? 

Dr. Meena Aserlind: Treatment can start just as simply as taking. And it's like ibuprofen. So you can do high dose of ibuprofen three times a day to help with the inflammation that comes from it. Other options are hormonal. So you can take birth control pills that have estrogen and progesterone in them that help suppress the ovaries? True treatment of endometrium requires suppression of the ovaries, because that's where the problems come from. And so estrogen and progesterone can help keep the ovaries from causing issues with pain. If that's not possible to be taken, you can do progesterone only. IUDs can be used as well to help with pain. Finally, if that doesn't work, or if you have very severe symptoms due to endometriosis, surgery is an option. It is not curative. It's not something that can fix endometriosis, but it can relieve a lot of the pain due to it. And then finally, if done with childbearing and symptoms are still persistent, you can remove the uterus and even remove both ovaries. If you're to a point where the disease has progressed outside just cycles. 

Rebecca Thomas: All right, we are out of time. But Dr. Meena Aserlind, thank you so much for sharing your time and your expertise with us tonight.