DRHOOK- Womb woe: Periodic disorder painful, hard to cure

Cloris Leachman is very funny. High Anxiety proved it. Remember those pointy breasts as Nurse Diesel? Still, I didn't know how raunchy she could be until I saw her roast Bob Saget. Oooh, child! 

Then she kept the censors for Dancing with the Stars jumping every time she was on air this past season because they didn't know what obscene, profane thing would come out of her. She was like Madonna on Letterman times four.

Cloris is 82 years old with many medical problems (as she mentioned on the first Dancing episode), but she moved as long as the young and vibrant Julianne Hough. It goes to show that age has nothing to do with perseverance. Hough, the professional dancer, was taken out by surgery for endometriosis. But then, as it's a competitive show, Lacey Schwimmer also announced she has endometriosis!

Is endometriosis that common?

Five million American women have endometriosis. Actually, it's hard to say how many really do because quite a few have it but don't have symptoms. For example, up to seven percent of women who are getting their tubes tied are found to have endometriosis. 

On the other hand, nearly half of all teenage girls with chronic pelvic pain or menstrual problems are found to have endometriosis during exploratory laparoscopy.

Endometriosis is a weird disorder because we aren't really sure how the endometrial tissue (normally found within the uterus) ends up outside the uterus. Maybe it migrates out through the Fallopian tubes? It might just develop within the pelvis and abdomen because of cells "transforming" into endometrial tissue. It could be from altered immune cells because endometriosis is associated with autoimmune inflammatory disease, hypothyroidism, fibromyalgia, and allergies.

We all hate pain– and that's the main issue, especially during the menstrual period, because bleeding occurs not only in the uterus but also wherever the tissue might migrate: ovaries, around the appendix (like Julianne Hough), sigmoid colon– but also really anywhere including the breasts, arms, legs, lungs, and spine. 

Cases of bruises under the skin have been attributed to endometrial tissue there! 

Pain is most common in the pelvis, and it can mimic Pelvic Inflammatory Disease (PID)– except there is no evidence of a sexually transmitted disease. For some, the pain is continuous, not occurring only during menstrual periods, making everyday a Midol day. 

More than pain, endometriosis is associated with infertility, discomfort during sex, and chronic fatigue. Because adhesions can occur (like scar tissue connecting internal tissues and organs), there can be bowel and bladder problems. 

Endometriosis occurs almost exclusively in females of reproductive years because endometrial tissue thrives on ovarian hormones. It seems to attack tall thin women in their mid-20s to mid-30s. Delayed pregnancy appears to be a risk factor, so professional women appear to have endometriosis more.

Surgery is the only cure because the tissue must be removed. When I was a medical student, I saw cases of endometriosis within the abdominal cavity and attached to different organs. But it was like mining for silver, because it's impossible to search every inch for endometrial tissue. 

How do you know if you get it all? How do you know that more won't grow elsewhere? Ultrasound and MRI can locate endometriosis regions, but often a woman with endometriosis will need more than one laparoscopy.

Hopefully with the growing awareness of endometriosis, there will be more research to find out the cause and the cure. We need to see our Dancing with the Stars ladies kicking, spinning, and jumping to the music– not in response to pain.


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.



Don't pay any attention to John Hong. He's an idiot who appears to fellow idiots to be intelligent. That's what makes him so dangerous. HE'LL KILL YOU FASTER THAN THE HADRON COLLIDER!

Thanks for the article. I would like to point out that one of the reasons for delayed pregnancy is associated w/ endo is b/c women with endo find it difficult to have pain and/or have sex. So, it's wrong to attribute it to a professional women's disease. Also, laporoscopy is the ONLY way to diagnose endometriosis. And the only way to obtain long-term relief is EXCISION surgery from an endometriosis specialist. not all ob/gyns are trained to remove endometriosis. WHY? they just aren't trained to do so. I have been to ob/gyn surgeons who were not endo specialists who simply burned the endo off, but didn't REMOVE/EXCISE it. That's why women have to have repeat laporoscopies b/c the gyn didn't remove all the endometriosis. Luckily, there are a handul of endometriosis excisions who are specialists. Please visit www.centerforendo.com or www.endometriosistreatment.org. Whatever you do, do not listen to a doctor who says that the only way to cure endo is through pregnancy, that is false. Also, don't listen to a doctor who recommends Lupron injections as treatment. This medication puts you into a pseudo-menopause, and can only be administered for 6 months, after which there's risk for loss of bone density. Specialists are the best bet.

Also, women with endo can often have a hard time getting pregnant, so i think this article kind of has the order reversed (saying that delayed childbearing is a risk factor). that's bull. also, endo is well - documented among women who have had babies, so it's not an issue of delayed childbearing. it's a very devastating illness. sadly, the women's helath community rarely gives it the attention it deserves.

Thank you for this article. I suffered many years of misdiagnosis, including being told, over and over again, that the pain is "all in your head," I had 3 useless laparascopies.

Finally, after being threatened with a hysterectomy before the age of 40 (which is NOT a cure), I had much success with acupuncture, a strict vegetarian diet, and homeopathy.

Even with that, menopause is a blessing. This is a terribly disabling disease, and I was never able to conceive.

Dr. Hook, I was diagnosed w/endo over 10 years ago. I have had hormone treatment, endo ablasion and every other treatment my long time OB/GYN could think of. After having my son, I broke down and had a hysterectomy. Since then, I have had 1 more laproscopy to remove yet more endo. During that particular operation, my Dr. removed several spots of endo along w/bowel adhesions. She told me there was some spots in my chest cavity that she did not mess with due to presence of major organs, etc. I am not familiar w/specific surgical procedures vs. types of Dr. I still have severe pain during intercourse, bowel movements and sometimes when I simply sit a certain way it feels like my insides are falling out. I seem to be living in a hot bath, w/a heating pad & on OTC meds that DO NOT HELP! What I guess I am asking is would you be willing to "take a look" or automatically refer me to a general surgeon or have me follow a different path? Also, does your office accept Humana Gold PFFS insurance? I left my Dr. of 10 years due to insurance change that was out of my hands. She is willing to get you any/all records necessary but says it may help if whoever I see takes a "fresh look" w/o any preconceived notion. I found you on the web & decided to email & see what happens. Thanks for all your work in this field & for the help you give to others. I hope I can be helped also. Thanks again, Cynthia Wagle