SOUTH PHILADELPHIA (WPVI) -- About one in every 10 women of child-bearing age develops endometriosis. It can be a debilitating and frustrating condition to deal with.
With help from doctors at Temple Health, 28-year-old Quanya Myers of South Philadelphia has a strategy for controlling it.
Myers says the abdominal pain came on suddenly, as she talked with a friend shortly after returning from study abroad.
"The worst cramp I've ever felt. I didn't know what to do about them, they would just keep coming," she recalls.
"It basically got so intense, I could not move," she adds.
Pain episodes occurred so often she put her dreams of a career in video production on hold.
"I had to let go of a few jobs. And it took a while to even get work," she says. And that job wasn't in her chosen field.
"It sent me into a really deep dark depression for a while," adding, "It really took over my life."
Myers was eventually diagnosed with Endometriosis, a condition in which tissue lining the uterus attaches outside the womb - most often in the pelvis around the uterus, or on the ovaries, bladder or bowel.
Hers is considered Stage 4 or severe, in which there are many deep implants and adhesions in the pelvis, along with large cysts on the ovaries.
"It can act up and react to changes in the hormones and that can cause pain," says Temple Health gynecologist and surgeon Dr. Isabel Eisner.
"Some women have infertility problems that can be attributed to endometriosis," she says.
"Some women will experience pain with bowel movements, urination, or intercourse," Dr. Eisner adds.
Dr. Eisner says diagnosis can take time, because the symptoms can vary, and because there's no easy, precise method to find it.
"It doesn't always show up on imaging. So I try to suppress the menstrual cycle and see if that helps," says Dr. Eisner.
That's often done with contraceptives - both oral and implantable.
Minimally invasive laparoscopic surgery is another approach to both diagnosis and treatment. In fact, Dr. Eisner says it is considered the gold standard.
"Evaluate the pelvis very carefully. We look for any evidence of endometriosis there, and any that we see, we try to take out," says Dr. Eisner.
While surgery helped Quanya with ovarian cysts, the endometrial tissue itself is too embedded to remove surgically.
So she works on managing the pain.
"I noticed that my endometriosis flare-ups are directly related to stress. So stress management is a big thing for me," she notes.
In addition to yoga and therapy, Quanya uses medical marijuana at the suggestion of her regular gynecologist, Dr. Tanise Branche of Temple Health.
The multi-layer prevention plan is working.
"I don't have many flare-ups at all. I actually can't even remember my last flare," she says.
Dr. Eisner says even after surgery, managing hormones is a must to prevent new tissue implants.
She urges any woman with pelvic pain to keep a journal of the dates and times, what it feels like, and any potential triggers.
It's important to determine whether endometriosis, or something else, is the cause.
"Not all pelvic pain is caused by endometriosis. And by the same token, not all women with endometriosis have pelvic pain," says Dr. Eisner.