Endometriosis Care - Oakdale ObGyn
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What is Endometriosis?

For millions of women suffering from endometriosis pain, finding long-term relief can be a frustrating journey. At Oakdale ObGyn, our gynecologic specialists have advanced training and skills in evaluating endometriosis and using the latest in non-surgical and minimally invasive surgical techniques to treat endometriosis.

Endometriosis (en-doe-me-tree-O-sis) affects 6 to 10 percent of women of childbearing age and is one of the most common sources of chronic pelvic pain in women of that same age.

Endometriosis occurs when the tissue that lines the inside of your uterus starts to grow outside of the uterus. The displaced tissue, called endometrial tissue or implants, adheres (sticks) to other soft tissue inside your abdomen, including your ovaries, fallopian tubes, bladder, or bowels.

Endometriosis is estrogen (hormone) dependent, meaning it requires estrogen to grow. This is why this condition usually affects women in their 20s and 30s, and often begins within a few years of a woman starting her period.

Virtual Visits: If you live outside the Twin Cities, we offer convenient virtual visits with our endometriosis specialist by using our secure and HIPPA compliant telemedicine technology. All you need is a smart phone or computer. To learn more or see if this is an option for you, contact comments@oakdaleobgyn.com or call 763-587-7000.

Read: “Endometriosis: Improving the path to better patient outcomes” by Dr. Matthew Palmer (Minnesota Physician, March 2018)

We aren’t sure what causes endometriosis. However, current science suggests that this condition has an autoimmune disorder component and may be genetic. Women with first degree relatives, such as a mom or sister, who have the disease are more likely to have it themselves.

Inside the abdomen, these endometrial implants act like normal tissue that lines the inside of your uterus. Each month, it gets thicker and bleeds (sheds) with your monthly period. This building and shedding of the tissue usually causes pain before your period, and sometimes during and after your period. Endometriosis may also lead to formation of scar tissue and cause infertility by damaging the fallopian tubes.

There are several factors that put you more at risk for endometriosis. These include:

  • Genetics: if your mother, sister or aunt has endometriosis
  • Age: generally affects women in their 20s and 30s
  • Autoimmune disorders
  • Chronic pelvic infections
  • Symptoms of Endometriosis

This condition affects every woman differently; symptoms vary person to person, as does the degree of pelvic pain. Sometimes, endometriosis is mistaken for other conditions that include irritable bowel syndrome, uterine fibroids, or pelvic inflammatory disease. Symptoms are often dismissed as normal.

Common endometriosis symptoms may include:

  • Heavy or painful periods
  • Painful sex
  • Chronic pelvic pain
  • Painful cramping, especially before your period
  • Pain with urination or having a bowel movement
  • Nausea, diarrhea, or constipation
  • Blood in your urine or stools
  • Unexplained infertility

The first step to determine if you have endometriosis is an office consultation. Your doctor will talk with you about your symptoms and the location of any pain. Your medical and family history is carefully considered. Following, other exams help diagnose endometriosis. These may include:

  • Pelvic exam: Your doctor will perform a pelvic exam to look at and feel pain sites and abnormalities that include cysts, scar tissue and nodules (hard tissue).
  • Pelvic ultrasound: A vaginal ultrasound may be performed to evaluate for the presence of ovarian cysts (or endometriosis) as well as significant scar tissue.
  • Laparoscopic surgery evaluation: Based on your symptoms, pain, and the results of the pelvic exam and ultrasound, your doctor may perform minimally invasive surgery, called laparoscopy, to confirm a diagnosis of endometriosis or rule out another condition. During this same-day procedure, your doctor will take tissue samples, or biopsies, of suspicious areas inside your abdomen. The samples are sent to a pathologist to be tested for the presence of endometriosis. This procedure may be a diagnostic evaluation for the presence of endometriosis but in many cases it is also the primary treatment method.

Based on the results of the pelvic exam and office testing, your Oakdale ObGyn doctor will talk with you about which option(s) are best for you. If your doctor suspects you have endometriosis, surgery is usually the primary therapy, followed by medications and lifestyle modifications for long-term maintenance once the endometriosis lesions have been removed. We will see you at one of our four clinics located in Maple Grove, Blaine, Plymouth, and Crystal.

Surgery for Endometriosis

If your endometriosis is determined to be clinically significant, surgery is often recommended. The goal is to remove as much of the abnormal tissue and scarring as possible and return your abdomen to its normal state.

Surgery is most commonly performed laparoscopically, which involves looking inside your abdomen with a slender camera and using instruments through small incisions near your belly button. Surgical options using either robotics or conventional methods may include:

  • Ablating, or burning, the endometrial implants and scar tissue
  • Resecting or cutting the abnormal implants out

If surgery is necessary, we’ll see you at Maple Grove Hospital or the North Memorial Outpatient Surgery Center at Maple Grove Hospital. On occasion, we also perform surgery at North Memorial Medical Center and the Blaine Surgery Center.

Pelvic Floor Physical Therapy for Endometriosis

Conditions like endometriosis often cause chronic pain patterns to develop that surgery or medications alone may not adequately treat. Our specialized pelvic floor physical therapy program is usually an important post-surgical treatment to help alleviate chronic pain due to endometriosis. The chronic pain is usually the result of hyper-sensitized pain-carrying nerves and overly tight pelvic floor and abdominal muscles caused by the effects of endometriosis.

Lifestyle Habits Affecting Endometriosis

Lifestyle habits – what you eat, how much you exercise and manage stress – can influence this estrogen- dependent condition. Our registered dietician can help you understand your nutrition options. Lifestyle strategies include:

  • Regular exercise
  • A diet high in fiber, vegetables and fruit, and low in red meat
  • Warm baths with Epsom salts
  • Avoidance of “inflammation producing” foods such as caffeine, alcohol and high-fructose corn syrup or other unhealthy sugars.

Read: “Eating Well While on Vacation” by Kim Plessel, MS, RDN, LD

Read: “Endometriosis: Hydration and Alcohol Consumption” by Kim Plessel, MS, RDN, LD

Pain Medications for Endometriosis

Your doctor may recommend over-the-counter non-steroidal anti-inflammatory medications that include naproxen (Aleve, others) or ibuprofen (Advil, others) to help you manage painful cramps before, during and after your period. Narcotic pain medications are generally used for post-surgery pain management only and are not a good strategy for dealing with the long term effects of chronic pain and endometriosis.

Oral Contraceptive, Hormone Therapy for Endometriosis

Medications to influence this estrogen-dependent condition are a common treatment option. Research shows hormone therapy can help reduce pain, prevent new implants, and possibly slow the growth of existing implants. Based on the symptoms of endometriosis, your doctor may recommend:

  • Oral contraceptives using a conventional, cyclic approach, where hormones are withheld for several days each monthly cycle. You will most likely have a menstrual period every month.
  • Oral contraceptives using a continuous approach, where low levels of estrogen are taken continuously. You may skip a menstrual period for several months.
  • Medically-induced hormone suppression or a state of temporary “menopause”, where estrogen is suspended for a short period of time, helping to slow the growth of endometriosis.

While medications can help to relieve symptoms, they generally do not cure endometriosis and are considered a temporary or adjunctive solution to surgery.

We’re proud to partner with Minnesota Endo Warriors, a local, nonprofit organization started and run by women with endometriosis. The group is dedicated to providing education, support, and access to critical resources for people with endometriosis. Our team, which includes physicians, a physical therapist, and a registered dietician, collaborates with MN Endo Warriors in a variety of ways, including initiatives related to the Worldwide EndoMarch, support groups, and other events throughout the year.

We also partner with Midwest Endometriosis Association, which is dedicated to improving the lives of people with endometriosis who live in the midwest. It offers education and advocacy to women who experience endometriosis, including support groups and community outreach.

Mpls.St.Paul Magazine recently announced their 2019 “Top Doctors Rising Stars” and we’re thrilled to say our own Dr. Matthew Palmer was named to this year’s list! Learn more
  • What is endometriosis?
  • Who is at risk for endometriosis?
  • Is there a genetic link?
  • Should my mother or sisters be checked for endometriosis?
  • Can it be cured?
  • What is the risk that it might return?
  • How long should I be monitored for endometriosis?
  • Is endometriosis related to cancer?
  • Can I get pregnant?
  • If I choose not to have surgery (only use medicines and lifestyle changes), what is likely to occur?
Causes

We aren’t sure what causes endometriosis. However, current science suggests that this condition has an autoimmune disorder component and may be genetic. Women with first degree relatives, such as a mom or sister, who have the disease are more likely to have it themselves.

Inside the abdomen, these endometrial implants act like normal tissue that lines the inside of your uterus. Each month, it gets thicker and bleeds (sheds) with your monthly period. This building and shedding of the tissue usually causes pain before your period, and sometimes during and after your period. Endometriosis may also lead to formation of scar tissue and cause infertility by damaging the fallopian tubes.

Risk Factors

There are several factors that put you more at risk for endometriosis. These include:

  • Genetics: if your mother, sister or aunt has endometriosis
  • Age: generally affects women in their 20s and 30s
  • Autoimmune disorders
  • Chronic pelvic infections
  • Symptoms of Endometriosis

This condition affects every woman differently; symptoms vary person to person, as does the degree of pelvic pain. Sometimes, endometriosis is mistaken for other conditions that include irritable bowel syndrome, uterine fibroids, or pelvic inflammatory disease. Symptoms are often dismissed as normal.

Common endometriosis symptoms may include:

  • Heavy or painful periods
  • Painful sex
  • Chronic pelvic pain
  • Painful cramping, especially before your period
  • Pain with urination or having a bowel movement
  • Nausea, diarrhea, or constipation
  • Blood in your urine or stools
  • Unexplained infertility
Diagnosis & Evaluation

The first step to determine if you have endometriosis is an office consultation. Your doctor will talk with you about your symptoms and the location of any pain. Your medical and family history is carefully considered. Following, other exams help diagnose endometriosis. These may include:

  • Pelvic exam: Your doctor will perform a pelvic exam to look at and feel pain sites and abnormalities that include cysts, scar tissue and nodules (hard tissue).
  • Pelvic ultrasound: A vaginal ultrasound may be performed to evaluate for the presence of ovarian cysts (or endometriosis) as well as significant scar tissue.
  • Laparoscopic surgery evaluation: Based on your symptoms, pain, and the results of the pelvic exam and ultrasound, your doctor may perform minimally invasive surgery, called laparoscopy, to confirm a diagnosis of endometriosis or rule out another condition. During this same-day procedure, your doctor will take tissue samples, or biopsies, of suspicious areas inside your abdomen. The samples are sent to a pathologist to be tested for the presence of endometriosis. This procedure may be a diagnostic evaluation for the presence of endometriosis but in many cases it is also the primary treatment method.
Treatment

Based on the results of the pelvic exam and office testing, your Oakdale ObGyn doctor will talk with you about which option(s) are best for you. If your doctor suspects you have endometriosis, surgery is usually the primary therapy, followed by medications and lifestyle modifications for long-term maintenance once the endometriosis lesions have been removed. We will see you at one of our four clinics located in Maple Grove, Blaine, Plymouth, and Crystal.

Surgery for Endometriosis

If your endometriosis is determined to be clinically significant, surgery is often recommended. The goal is to remove as much of the abnormal tissue and scarring as possible and return your abdomen to its normal state.

Surgery is most commonly performed laparoscopically, which involves looking inside your abdomen with a slender camera and using instruments through small incisions near your belly button. Surgical options using either robotics or conventional methods may include:

  • Ablating, or burning, the endometrial implants and scar tissue
  • Resecting or cutting the abnormal implants out

If surgery is necessary, we’ll see you at Maple Grove Hospital or the North Memorial Outpatient Surgery Center at Maple Grove Hospital. On occasion, we also perform surgery at North Memorial Medical Center and the Blaine Surgery Center.

Pelvic Floor Physical Therapy for Endometriosis

Conditions like endometriosis often cause chronic pain patterns to develop that surgery or medications alone may not adequately treat. Our specialized pelvic floor physical therapy program is usually an important post-surgical treatment to help alleviate chronic pain due to endometriosis. The chronic pain is usually the result of hyper-sensitized pain-carrying nerves and overly tight pelvic floor and abdominal muscles caused by the effects of endometriosis.

Lifestyle Habits Affecting Endometriosis

Lifestyle habits – what you eat, how much you exercise and manage stress – can influence this estrogen- dependent condition. Our registered dietician can help you understand your nutrition options. Lifestyle strategies include:

  • Regular exercise
  • A diet high in fiber, vegetables and fruit, and low in red meat
  • Warm baths with Epsom salts
  • Avoidance of “inflammation producing” foods such as caffeine, alcohol and high-fructose corn syrup or other unhealthy sugars.

Read: “Eating Well While on Vacation” by Kim Plessel, MS, RDN, LD

Read: “Endometriosis: Hydration and Alcohol Consumption” by Kim Plessel, MS, RDN, LD

Pain Medications for Endometriosis

Your doctor may recommend over-the-counter non-steroidal anti-inflammatory medications that include naproxen (Aleve, others) or ibuprofen (Advil, others) to help you manage painful cramps before, during and after your period. Narcotic pain medications are generally used for post-surgery pain management only and are not a good strategy for dealing with the long term effects of chronic pain and endometriosis.

Oral Contraceptive, Hormone Therapy for Endometriosis

Medications to influence this estrogen-dependent condition are a common treatment option. Research shows hormone therapy can help reduce pain, prevent new implants, and possibly slow the growth of existing implants. Based on the symptoms of endometriosis, your doctor may recommend:

  • Oral contraceptives using a conventional, cyclic approach, where hormones are withheld for several days each monthly cycle. You will most likely have a menstrual period every month.
  • Oral contraceptives using a continuous approach, where low levels of estrogen are taken continuously. You may skip a menstrual period for several months.
  • Medically-induced hormone suppression or a state of temporary “menopause”, where estrogen is suspended for a short period of time, helping to slow the growth of endometriosis.

While medications can help to relieve symptoms, they generally do not cure endometriosis and are considered a temporary or adjunctive solution to surgery.

Support & Education

We’re proud to partner with Minnesota Endo Warriors, a local, nonprofit organization started and run by women with endometriosis. The group is dedicated to providing education, support, and access to critical resources for people with endometriosis. Our team, which includes physicians, a physical therapist, and a registered dietician, collaborates with MN Endo Warriors in a variety of ways, including initiatives related to the Worldwide EndoMarch, support groups, and other events throughout the year.

We also partner with Midwest Endometriosis Association, which is dedicated to improving the lives of people with endometriosis who live in the midwest. It offers education and advocacy to women who experience endometriosis, including support groups and community outreach.

Mpls.St.Paul Magazine recently announced their 2019 “Top Doctors Rising Stars” and we’re thrilled to say our own Dr. Matthew Palmer was named to this year’s list! Learn more
Questions to Ask Your Provider
  • What is endometriosis?
  • Who is at risk for endometriosis?
  • Is there a genetic link?
  • Should my mother or sisters be checked for endometriosis?
  • Can it be cured?
  • What is the risk that it might return?
  • How long should I be monitored for endometriosis?
  • Is endometriosis related to cancer?
  • Can I get pregnant?
  • If I choose not to have surgery (only use medicines and lifestyle changes), what is likely to occur?
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