ENDOMETRIOSIS
Endometriosis is a condition in which the endometrial tissue that normally covers the inside of the uterus grows in a location outside of the uterus.
- Endometrial tissue consists of blood cells, connective tissue and gland and normally forms in the uterus, to prepare the womb for ovulation.
- As the tissue continues to respond to menstrual cycle hormones, endometriosis forms deep inside the body and may cause scar tissues or painful adhesion.
- Endometriosis is a common disorder of the female reproductive organ, affects about 6%-10% of women in the reproductive age and is the leading cause of chronic pelvic pain in women.
- Endometriosis usually involves the ovaries, fallopian tubes, and the tissue lining the pelvic organs. However, in rare cases, it may also develop in other parts of the body including the brain, or lung.
- Endometriosis can be minimal, mild, moderate or severe depending on the location, the extent and the depth of the growth.
- Minimal or mild endometriosis result in mild scarring, while moderate and severe endometriosis results in more severe scarring.
- Severe endometriosis causes infertility.
CAUSES
Although the exact cause of endometriosis is uncertain, possible theory and explanations include:
- Immune system disorder
- Surgical scar implantation
- Endometrial cell transfer via the bloodstream or the lymphatic system. This is responsible for the rare cases of endometriosis found in the brain, or lung.
- Retrograde Menstruation. Menstrual flow containing endometrial tissue may flow back through the fallopian tubes into the pelvic and abdominal cavity, leading to a deposition of the endometrial tissue at unusual locations.
- Peritoneal cell transformation. The cells lining the pelvic organs may transform into other forms of tissue such as endometrial tissue.
Several factors can make you vulnerable and place you at a greater risk of developing endometriosis, such as:
- Low body mass index
- Early period
- Late menopausal stage
- Family history
- Alcohol consumption
- Uterine abnormalities
SYMPTOMS
- Painful periods
- Pelvic pain
- Excessive bleeding during menstruation
- Infertility
- Discomfort with bowel movements or urination
- Pain following sex
- Other symptoms may include diarrhea, constipation, fatigue, nausea, and vomiting, or headaches.
The severity of your pain doesn’t indicate the degree or extent of your condition. Some women may have severe pain but may have a mild form of the disease, while some women may have little pain or discomfort but may have a severe form of the disease.
DIAGNOSIS
To diagnose endometriosis, your doctor will ask you questions about your symptoms including the location of your pain and when it happens.
For an accurate diagnosis, your doctor may conduct certain tests to check for endometriosis, this test may include:
- Pelvic exam
- Ultrasound
- Your doctor may refer you to a surgeon to look inside your abdomen for signs of endometriosis in a procedure called laparoscopy. This is the most common surgical procedure used for the diagnosis of endometriosis. During this procedure, biopsies can also be performed in order to obtain a tissue diagnosis.
TREATMENT
Endometriosis can be treated with medications and/or surgery. The aim of treatment is to relieve symptoms and enhance fertility.
Your doctor may recommend pain relief such as nonsteroidal anti-inflammatory drugs to help with painful menstruation.
Hormone therapy or medications may be effective in easing or eliminating pain. This may include hormonal contraceptives, Gonadotropin-releasing hormone analogs (GnRH analogs), progestin therapy, or danazol.
Surgery may be conservative or definitive and can be useful when the symptoms are severe or there has been little response to other treatment
If you have endometriosis and you are trying to conceive, conservative surgery may be recommended to remove as much endometriosis as possible while preserving your ovaries and uterus. This surgery may increase your chances of getting pregnant.
Definitive surgery involves removal of the uterus, with or without the ovaries and can be very effective in easing the pain.