Endometriosis

Endometriosis

Endometriosis is the manageable gynaecological condition that occurs when endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body. As the tissue continues to thicken, break down, respond to menstrual cycle hormones, and bleed during the menstrual cycle, endometriosis forms deep inside the body. Endometriosis is thought to affect around 15% of women.

  • Endometriosis affects between 15% of women of reproductive age worldwide.
  • The condition appears to be present in a developing foetus, but oestrogen levels during puberty are thought to trigger the symptoms.
  • Symptoms are generally present during the reproductive years.
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    What is endometriosis ?

    Endometrial tissue consists of gland, blood cells, and connective tissue. It normally grows in the uterus, to prepare the lining of the womb for implantation of embryo. When they grow outside the uterus, this is called endometriosis.

    They can develop anywhere in the body, but they usually occur in the pelvic area. They may affect:

  • The ovaries
  • The fallopian tubes
  • The peritoneum
  • The lymph nodes
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    Normally, this tissue is expelled during menstruation, but endometriotic tissue cannot do this. This leads to physical symptoms, such as pain. As the lesions grow larger, they can affect bodily functions. For example, the fallopian tubes may be blocked.

    The pain and other symptoms can affect different areas of life, including the ability to work, medical care costs, and difficulty maintaining relationships.

    Symptoms

    Other medical conditions such as pelvic inflammatory disease (PID), ovarian cysts, and irritable bowel syndrome (IBS) can mimic the symptoms of endometriosis.

    Symptoms of endometriosis include:

  • Severe menstrual cramps, unrelieved with NSAIDS
  • Long-term lower-back and pelvic pain
  • Periods lasting longer than 7 days
  • Heavy menstrual bleeding where the pad or tampon needs changing every 1 to 2 hours
  • Bowel and urinary problems including pain, diarrhoea, constipation, and bloating
  • Bloody stool or urine
  • Nausea and vomiting
  • Fatigue
  • Pain during intercourse
  • Spotting or bleeding between periods
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    Pain is the most common indication of endometriosis, but the severity of the pain does not always correlate with the extent of the disease. Pregnancy may provide temporary relief from symptoms.

    Complications

    Complications include:

  • infertility, which can affect 50 percent of those with the condition.
  • increased risk of developing ovarian cancer or endometriosis-associated adenocarcinoma
  • ovarian cysts
  • inflammation
  • scar tissue and adhesion development
  • intestinal and bladder complications
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    It is important to talk to us about symptoms, to avoid future complications.

    Causes

    The exact cause of endometriosis is not currently fully understood. Possible explanations include:

  • Problems with menstrual flow: Menstrual blood enters the fallopian tubes and the pelvis instead of leaving the body in the usual way.
  • Embryonic cell growth: At times, embryonic cells lining the abdomen and pelvis develop into endometrial tissue within those cavities.
  • Fetal development: Data show that endometriosis can be present in a developing fetus, but pubertal estrogen levels are thought to trigger the symptoms.
  • Surgical scar: Endometrial cells can move during a procedure such as Hysterotomy or c-section.
  • Endometrial cell transport: The lymphatic system transports endometrial cells to various parts of the body.
  • Genetics: There may be an inherited component. A woman with a close family member who has endometriosis is more likely to develop endometriosis herself.
  • Hormones: Endometriosis is stimulated by the hormone estrogen.
  • Immune system: Problems with the immune system can prevent the destruction of extrauterine endometrial tissue.
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    Treatment

    Surgery is possible, and normally considered if the other treatments are not effective like:

  • NSAIDS - Pain relievers are used for the treatment of painful menses.
  • Hormones - Therapies such as birth control, GnRH agonists and antagonists, Medroxyprogesterone or Danazol are used. Placement of IUd is also recommended.
  • Surgery - Areas of endometriosis may be removed or a hysterectomy with the removal of both ovaries may be necessary.
  • Fertility treatment - Pregnancy may be recommended via IVF.
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    Although there is no cure for endometriosis, most women are able to relieve the pain of symptoms and will still be able to have children.