Endometriosis Specialist Northern Virginia and Fibroids: What to Know

Endometriosis Specialist Northern Virginia and Fibroids: What to Know

Pelvic pain, heavy periods, and fertility challenges are common reasons people in Northern Virginia seek answers from an endometriosis specialist. Two conditions often at the center of these concerns are endometriosis and uterine fibroids. While they can share symptoms, they are distinct disorders requiring tailored evaluation and treatment. Here’s what to know—and how to find the right care in Northern Virginia.

Endometriosis and Fibroids at a Glance

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, commonly on the ovaries, fallopian tubes, or pelvic lining. It can cause inflammation, scarring, and pain, particularly around menstruation. The condition affects millions of reproductive-age individuals and can impact quality of life and fertility. Learn more from the NIH and HHS Office on Women’s Health (NIH/NICHD, OWH).

Uterine fibroids (leiomyomas) are noncancerous growths of the uterine muscle. They vary in size and number and can distort the uterine cavity or wall. Fibroids are very common and often asymptomatic, but they may cause heavy menstrual bleeding, pelvic pressure, pain, and fertility or pregnancy complications. Trusted overviews: MedlinePlus and ACOG.

Overlapping Symptoms—and Key Differences

  • Pain: Endometriosis classically causes painful periods (dysmenorrhea), deep pain with sex, painful bowel movements or urination during menses, and chronic pelvic pain. Fibroid pain is more often described as pressure or cramping, sometimes with back or leg pain when large.
  • Bleeding: Fibroids are a leading cause of heavy or prolonged menstrual bleeding and anemia. Endometriosis can also contribute to irregular bleeding, but heavy bleeding is more strongly associated with fibroids.
  • Fertility: Both conditions can be linked to infertility—endometriosis through inflammation and scarring, fibroids by distorting the uterus or blocking fallopian tubes.
  • Location: Endometriosis typically occurs outside the uterus; fibroids grow within the uterine muscle or cavity.

When to See an Endometriosis Specialist in Northern Virginia

Consult a specialist if you have:

  • Severe menstrual pain not relieved by over-the-counter medicines
  • Heavy bleeding that soaks through pads/tampons in under 2 hours or lasts more than 7 days
  • Chronic pelvic pain, pain with sex, or pain with bowel movements or urination
  • Difficulty getting pregnant
  • A known diagnosis of fibroids with symptoms affecting quality of life

Northern Virginia residents can access subspecialists in minimally invasive gynecologic surgery (MIGS), reproductive endocrinology and infertility (REI), and interventional radiology. Large health systems and DC-area academic centers offer multidisciplinary pelvic pain clinics—helpful for complex endometriosis and coexisting fibroids. Ask your primary OB-GYN for a referral and verify insurance and referral requirements in advance.

How Specialists Diagnose These Conditions

A comprehensive evaluation typically includes a detailed medical history, pelvic exam, and imaging:

  • Pelvic ultrasound: First-line imaging for fibroids; can also detect ovarian endometriomas.
  • MRI: Useful for surgical planning, mapping fibroids, or evaluating deep endometriosis.
  • Diagnostic laparoscopy: Minimally invasive surgery is the gold standard for confirming and treating endometriosis when indicated (ACOG).
  • Hysteroscopy: Visualizes the uterine cavity when submucosal fibroids or polyps are suspected.

Evidence-Based Treatment Options

Endometriosis

  • Pain management and hormones: NSAIDs, combined oral contraceptives, progestin-only pills, depot medroxyprogesterone, and levonorgestrel IUDs can reduce pain and bleeding (ACOG).
  • GnRH therapies: GnRH agonists and antagonists decrease estrogen to suppress lesions. The FDA has approved the oral GnRH antagonist elagolix for moderate-to-severe endometriosis pain; add-back therapy helps mitigate bone loss (FDA).
  • Surgery: Laparoscopic excision or ablation can relieve pain and may improve fertility in select patients. Choice depends on disease extent, symptoms, and goals.
  • Fertility planning: Early referral to REI can be beneficial if pregnancy is a priority.

Uterine Fibroids

  • Watchful waiting: Appropriate when symptoms are mild or nearing menopause.
  • Medical therapy: NSAIDs for cramps; tranexamic acid for heavy bleeding; hormonal options (combined pills, progestins, levonorgestrel IUD). The FDA approved the oral combination elagolix/estradiol/norethindrone acetate for heavy menstrual bleeding associated with fibroids in premenopausal patients (FDA).
  • Uterus-sparing procedures:
    • Myomectomy (laparoscopic, hysteroscopic, or open) removes fibroids while preserving the uterus—often preferred for fertility.
    • Uterine artery embolization (UAE/UFE) shrinks fibroids by blocking their blood supply; recovery is typically shorter than surgery. See ACOG’s patient FAQ (ACOG).
    • MRI-guided focused ultrasound is a noninvasive option available at select centers and cleared by the FDA for uterine fibroids (FDA).
  • Hysterectomy: Definitive treatment for those who do not desire future fertility.

Note: For some fibroid surgeries, the FDA advises caution with laparoscopic power morcellation due to the risk of spreading unsuspected cancer; discuss alternatives and containment systems with your surgeon (FDA safety communication).

Fertility and Pregnancy Considerations

Endometriosis can affect egg quality, tubal function, and implantation. Fibroids, particularly those distorting the uterine cavity, may reduce implantation rates and increase miscarriage risk. A fertility-focused consultation helps tailor a plan—whether that’s timed intercourse, ovulation induction, intrauterine insemination, IVF, surgical optimization (e.g., excision of endometriosis or removal of cavity-distorting fibroids), or a combination. Timing matters; earlier evaluation can expand options.

Preparing for Your Appointment

  • Track symptoms for 2–3 cycles: pain scores, bleeding days, clots, missed work/school, bowel or bladder symptoms.
  • List prior treatments, imaging, surgeries, and medications (including supplements).
  • Clarify goals: pain relief, preserving fertility, controlling bleeding, or avoiding surgery.
  • Ask about the care team: minimally invasive surgeons, pelvic floor physical therapy, pain management, and mental health support.
  • Discuss recovery time, recurrence rates, and long-term follow-up.

Accessing Care in Northern Virginia

Northern Virginia offers robust access to OB-GYNs, MIGS surgeons, interventional radiologists, and fertility specialists. Consider:

  • Insurance coverage and referral requirements
  • Availability of advanced imaging and minimally invasive procedures
  • Coordination with DC-area academic centers for complex cases
  • Telemedicine for follow-ups and medication management

Trusted Sources and Further Reading

This article is for informational purposes and does not replace personalized medical advice. If you have symptoms or concerns, consult a qualified clinician.

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