Endometriosis is a condition in which the tissues of the inner lining of the uterus, the endometrium grows outside the uterus. Mostly the tissues grow on ovaries and fallopian tubes. Rarely it was seen on other parts of the body. The main symptoms of endometriosis are pelvic pain and infertility. Diagnosis is based on the symptoms along with medical imaging techniques.
Causes of endometriosis:
The main theories for the formation of endometriosis are retrograde menstruation, coelomic metaplasia, and transplantation.
- Retrograde menstruation
During menstruation, some debris of endometrium flows back to the fallopian tubes and peritoneal cavity and attaching itself to the peritoneal surface. These displaced endometrial tissues then act like normal endometrium during each menstrual period. They get thicken, break down and bleed during those days. Then causes severe pain, adhesion to other organs and infertility.
- In rare cases, due to the imperforated hymen during the first menstrual cycle, the blood and the endometrium reside within the uterus and cause0020the same symptoms.
The conversion of the pelvic tissues into endometrial tissues causes similar symptoms.
- Having a first pregnancy at an older age.
- First periods before 11 years of age
Signs and symptoms of endometriosis:
This is the major symptom of endometriosis. The pain ranges from mild to severe, which is stabbing or cramping in nature, in the lower back, lower abdomen and even down the legs.
Painful cramps during the menstrual period, which aggravates on time.
Painful sexual intercourse
Urinary urgency increased frequency and pain during voiding.
-Those with the deep disease appear to be more likely to have shooting rectal pain and a sense of their inside being pulled down.
The pathogenesis of infertility depends on the stage of the disease. In early stages, the inflammatory response becomes the reason and in late stages distorted pelvic anatomy and adhesions contribute to impaired fertilization.
-Other symptoms include constipation, nausea, vomiting, fatigue, headache, heavy and irregular periods and hypoglycemia.
- Magnetic resonance imaging
- Pain quantification
Treatment of endometriosis:
Treatment of endometriosis involves medication and surgery. The approach is selected depends on how severe the signs and symptoms are.
1. Pain medication
The doctor may recommend taking an over-the-counter pain reliever such as Nonsteroidal anti-inflammatory drugs (NSAIDs), ibuprofen, or naproxen sodium to reduce the painful cramps.
2. Hormone therapy
Supplemental hormones can reduce the pain of endometriosis. The variations in hormone level cause thickening, breaking down and bleeding of the endometrial implants. Hormone therapy is not a permanent choice, the symptoms can be returned once you stop the supplements.
- Hormone contraceptives
Birth control pills, patches, and vaginal rings control the hormone which is responsible for the growth of endometrial implants. Hormonal contraceptives help in reducing the pain.
- Gonadotropin-releasing hormone agonist and antagonist
- Progestin therapy
It includes an intrauterine device with levonorgestrel, contraceptive implants, and contraceptive injection which can halt the menstrual cycle and growth of implants.
3. Conservative surgery
If the woman has endometriosis and she is trying to get pregnant, then surgery can be done to remove the endometrial implants by preserving the uterus and ovaries. The procedure increases the chance of pregnancy and helps in reducing severe pain.
4. Complete hysterectomy
This is the surgery in which the uterus along with ovaries is removed. Even if the ovaries are left in place, hysterectomy has a long-term effect on your health.
Frequently Asked Questions
The actual cause of endometriosis is not yet known. But studies have proven that first degree relatives of a woman with endometriosis have a seven-fold risk of developing endometriosis.
Even if they are much easier to manage the symptoms of endometriosis, it has a range of side effects. Blood clots may form and it will cause many complications.
Women with endometriosis have a mild risk of development of certain types of ovarian cancer, known as epithelial ovarian cancer. The risk is highest in women having endometriosis and primary infertility. But the use of oral contraceptive pills which reduce the symptoms of endometriosis appears to significantly reduce the risk.
Endometriosis is rare in postmenopausal women. It is mostly seen in women within the age group of 25-35 years. In most cases, the symptoms of endometriosis are reduced after menopause because the size of implants becomes smaller.
Some women have not a single symptom even though their endometriosis is extensive. It means that the affected area is very large and or there is scarring. But in some women, the symptoms are very severe even with a mild area of endometriosis.
Endometriosis is a painful disorder in which the inner lining of the uterus, the endometrium grows outside the uterus. The endometrial parts outside the uterus thicken, breaks down and bleeds like the normal endometrium. … Read More