I have endometriosis. I lived with it for many years before diagnosis. I had laparoscopy and laser, and it was diagnosed as severe. Three months later I had a hysterectomy. That was a year and a half ago, and now the symptoms have returned. I believe there is a possibility of endo on my colon and possibly abdomen. I know that endo can cause many problems when on the colon and abdomen. Has anyone ever died from the effects of endo, when left untreated? Joyce

I am not aware of people dying directly due to endometriosis, but certainly complications from endometriosis surgery, or for that matter any pelvic surgery, can result in death. Endometriosis is a chronic condition that apparently occurs when bits of the endometrial lining passes through the fallopian tubes and onto the abdominal surfaces. These endometrial cells can attach to the peritoneal surfaces (lining of the abdominal cavity), the colon, the rectum, the bladder and other structures. Hysterectomy should cure the condition ... but it doesn't. One of the worst cases I know of, which required a bowel and partial bladder resection, occurred about 10 years after the patient had her uterus removed because of fibroid tumors. It is interesting to note that she had no evidence of endometriosis at the time of hysterectomy!

While most women who have hysterectomy have relief of their symptoms, for those who still have their ovaries or are placed on estrogen-only hormone replacement therapy, microscopic endometrial cells can continue to grow. Often removing the ovaries, temporarily halting hormone replacement therapy, or adding micronized progesterone to the hormone replacement regimen will alleviate the symptoms. For more information, see my previous columns on endometriosis.