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Expert Q&A

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Can endometriosis recur?

Asked by Julie, Fort Thomas, Kentucky

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I was wondering whether endometriosis can return. Mine was diagnosed while I was trying to get pregnant about seven years ago. I had surgery to remove the scar tissue, was on different drugs and took time off from work to treat it and was finally blessed with two sons. But since the birth of my second son almost four years ago, I've been trying to get pregnant again, with no luck. My age (39) may be a factor, but I'm starting to have some of the endo symptoms as well.

I thought I was cured. What gives? Thanks.

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Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Dear Julie:

Yes. Endometriosis can return after being quiet for some time.

Endometriosis is the presence of endometrial tissue (that is supposed to be only in the uterus) outside the uterus and in the pelvis or abdomen. It can be asymptomatic but can also cause pelvic pain (which can be continuous and is often more severe during your period or at ovulation). It can also cause irregular menstruation, painful menstruation, decreased fertility or infertility, bowel and bladder symptoms and fatigue.

It can be confused with pelvic infections and inflammatory disease and bowel problems. Today, it is most commonly diagnosed by laparoscopy. In laparoscopy, a scope is placed inside the abdomen, allowing the surgeon to see the disease.

Treatments include pain medicines; sometimes just ibuprofen works. Others need stronger medications. Hormonal therapies that include oral contraceptives and other drugs are also used. Surgical removal of the lesions from the abdomen (usually by laparoscopy) is also helpful. Pregnancy can cause the disease to quiet down. But it can relapse several years after a pregnancy or successful treatment.

I would encourage any woman who thinks she might have the symptoms above to seek medical evaluation. The symptoms are very vague and can be signs of a number of other diseases needing treatment, some minor such as infections and some major such as ovarian cancer.

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