Ask Dr. Bob: Know About Endometriosis as a Cause of Pelvic Pain

Dear Dr. Bob:
"I have had problems with severe menstrual cramps and pelvic pain since I was 13. At that time, my doctor told me that I likely had endometriosis. I was given Naproxen, which is an anti-inflammatory medication or NSAID, for pain and placed on the birth control pill - neither of which helped a whole lot. Now as a married adult I am having trouble getting pregnant. I consulted a fertility specialist and was told that my best option for having a baby was in vitro fertilization [IVF]. I am uncomfortable with this option because IVF results in "embryo wastage"- freezing or destruction of unused embryos, and I believe that human life begins at conception. I had heard about NaPro Technology from a friend who said this might be helpful to me. Can you explain?

Dr. Bob Responds: 
You have asked a pretty complex question here. I will try to address your question in the following sections:

First: What is endometriosis and who is affected?

Endometriosis is a common condition that can cause painful menstrual cramps [dysmenorrhea], pelvic pain, irregular cycles and/or infertility in adolescents and adults. It is frequently first noticed during the teenage years. According to a review in Up-to-Date, an online medical textbook, the disease has been reported in 25 to 38 percent of adolescents with chronic pelvic pain and 47 percent of those with chronic pelvic pain that undergo laparoscopy, a surgical procedure done through 1-4 "mini-incisions."[1] Among adolescents undergoing surgery for pelvic pain not controlled with oral contraceptive pills [OCs] and NSAIDS, endometriosis was found 50 to 70 percent of the time. So, it's not surprising that your symptoms were not completely relieved with the treatment you received. I am also hopeful that your doctor evaluated you for other causes of pelvic pain, which can include ovarian cysts, sexually transmitted infections and problems affecting other organs like your bladder or intestines.

Endometrial implants are pieces of endometrial tissue, similar to that found in the lining of your uterus, except that these implants live on other surfaces within the abdomen-outside of the uterus. Under the influence of your cyclic hormones endometrial implants swell and become inflamed. The inflammation causes pain and can also disrupt monthly hormone patterns, potentially contributing to infertility. Endometriosis can cause blockage of ovarian tubes and irritation of other pelvic organs and tissues. 

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Dr. Bob Motley is the 2013 Recipient of the Drs. Gino and Mary Papola Award for his outstanding contributions to Catholic Health Care in service to Christ and His Church.

Dr. Bob is an FFC Board Member and involved in its Mission.  He  was the previously the Director of the Philadelphia Catholic Medical Association Medical Student programs and is a guiding force in the education of medical professionals and couples in the use of Natural Family Planning.   

The Friends of FertilityCare Philadelphia are a group of health care professionals and members of our community who wish to promote effective, integrated health care for women and couples. To that end, the Friends of FertilityCare are dedicated to making Creighton Model FertilityCare services and NaProTechnology known, respected and applied throughout the Greater Philadelphia region. The primary intention of the Friends of FertilityCare is to educate all people in the "good news" of Creighton Model FertilityCare System and NaProTechnology.