Endometriosis

Endometriosis is a condition in which the tissue lining the uterus grows outside the uterus. In some of the most frequent cases, the endometrium (the lining tissue of the uterus), the ovaries and the fallopian tubes are involved in the issue. In rare cases, the tissue might grow outside the pelvic cavity. Endometriosis is a painful condition that is affecting more than 10 million women worldwide. Out of these, 25% show no symptoms of the condition. Exposed to develop endometriosis are women in their 40s and 50s. However, it can affect younger women as well.

Endometriosis Overview & Facts

Women suffering from endometriosis have the tissue lining the uterus overly developed. However, even if there is an abnormality the woman’s uterus continues to act normally, having menstrual cycles. Unfortunately, the tissue that is usually eliminated during menstruation days has no ways of exiting the body, remaining trapped inside. This leads to cyst formation, cysts that are known in the profile literature as endometriomas. In many cases, the surrounding tissue becomes irritated, affection that leads to scar tissue formation. Another abnormality present in women suffering from this condition is adhesion formation, a type of band that facilitates and promotes the internal organs to stick together or stick to the pelvic tissue. Tissue growth appears as a result of the inflammation, but worth mentioning is the fact that this type of growth is not malign. Needless to say, the condition is extremely painful in many cases. However, 25% of the women diagnosed with this condition never show any signs or symptoms.

 

Endometriosis Symptoms & Diagnosis

Symptoms of Endometriosis

The cause of the condition remains unclear. However, there is the genetic factor that plays a great role in the condition. Many women that are diagnosed with endometriosis claim that their mother’s also struggled with the condition. The first sign of endometriosis is pelvic pain, during or outside the menstrual days. While most of the women experience pain while menstruating, women with endometriosis describe it as excruciating. More than this, the pain seems to escalate in time. Some of the most commons symptoms of endometriosis are as described below.

  • Dysmenorrhea – painful periods, extreme cramps during and after the period.
  • Pain during intercourse – due to the scar tissue formation and continuous inflammation of the uterus wall, women with endometriosis experience painful intercourse.
  • Painful urinating or bowel movement – especially present in the period interval.
  • Heavy bleeding during periods.
  • Bleeding between periods (menometrorrhagia).

 

Although all these endometriosis symptoms are present especially during periods, women with endometriosis also experience these outside it. While the pain experienced during periods is one of the indicators of the disease, it doesn’t always indicate the condition. Many women in advanced stages of endometriosis never experience pain, for instance. Also, the condition can be easily mistaken for other conditions such as inflammatory pelvic disease, ovarian cysts, and irritable bowel disease.

During pregnancy, women with endometriosis notice that their symptoms end, and reoccur after the pregnancy. In women at menopause, the symptoms will end permanently.

Diagnosis of Endometriosis

The presence of several symptoms presented above should alarm women. Medical imaging is one way of diagnosing endometriosis.

Laparoscopy is an intervention which may prove the presence of outgrown endometrial tissue and is one of the most secure endometriosis diagnosis methods. Through a small incision, an internal camera is introduced in the pelvic cavity in order to detect the presence of abnormal tissue. However, in many cases the growths are not visible to the naked eye, case in which a biopsy is necessary.

Endometriosis is divided into four categories or stages, as they are also known, depending on the condition’s severity. Stage I is the least severe, while stage IV is an extreme form of the condition.

 

Endometriosis Symptoms

 

What Causes Endometriosis?

Although the causes of endometriosis are unclear, there are some other conditions that may lead to the disease.

  • Endometrial cell transport – the blood cells or the lymphatic system may become mixed with endometrial cells, which may be transported to other areas of the body.
  • A retrograde menstruation in this affection menstrual blood, mixed with endometrial cells flows backwards on the fallopian tubes and reaches once again the pelvic cavity. These endometrial cells stick to the cavity walls and surrounding organs, leading to tissue growth.
  • Mutated peritoneal cells – certain experts claim that certain hormones may lead to peritoneal cells’ conversion in endometrial cells. The peritoneal cells are the cells that line in the inner pelvic cavity and some experts claim that certain mutations may occur in those.
  • An immune system disorder – in some cases, it is very likely that the women’s immune system not to be able to recognize the endometrial cells that are located outside the endometrial wall, and thus destroy those. This leads to excessive endometrial tissue formation.
  • Embryonic cell mutations – in many cases, embryonic cells in early development stages might be mutated into endometrial cells, a phenomenon that leads to tissue growth.
  • Surgical scar implantation – after certain surgeries located near the pelvic area, endometrial cells may relocate in the scar tissue formed.

Endometriosis Risk Factors

In terms of endometriosis risk factors, specialists have identified a list of variables that may increase a woman’s chances of developing endometriosis.

  • Women who had their first period at a young age.
  • Women who never gave birth.
  • Delayed menopause.
  • Periods which are shorter than 27 days.
  • BMI lower than normal.
  • Substance abuse – alcohol, especially.
  • A family medical history of endometriosis – genetic factors.
  • High estrogen levels.
  • A series of medical conditions that prevent a normal flow of the menstrual blood.
  • Toxins in the environment – dioxins – are another risk factor for women to develop endometriosis, as a study in 2004 has proved.

Endometriosis Complications

Unfortunately, endometriosis is also leading to severe complications, besides the excruciating pain oftentimes experienced. The most severe endometriosis complications are infertility and ovarian cancer.

  • Endometriosis and Infertility – infertility is one of the most common complications that occur in women with endometriosis. Almost 33% of those suffering from the condition find it difficult to remain pregnant without medical assistance. In case of endometriosis, the fallopian tube is obstructed. This leads to the sperm’s incapacity to fecundate the egg. In women of young age, surgical removal of the tissue from the ovaries with their preservation is one of the therapies recommended, especially if the woman is aiming to bear a pregnancy in the future. Also, it has been proven that in vitro fertilization increases significantly the changes of a pregnancy.
  • Chocolate cyst ovaries syndrome – is caused by the blood buildup in the ovaries, a phenomenon that is frequent in endometriosis. A common therapy for this syndrome is the administration of non-steroidal anti-inflammatory medication. Hormonal contraception may be used in order for the an-ovulary phase to be achieved. Ultimately, if necessary, a surgery will be performed on the patient, in order to remove the abnormality. However, experts do not recommend laser removal surgeries, as there is certain proof that the syndrome reappears after a certain interval.
  • Ovarian cancer – ovarian cancer is considerably more frequent in women with endometriosis. Because the ovarian tissue is suffering modifications and abnormalities appear, in approximately 20% of the women that suffer from endometriosis, there will appear at a time or another, a form of endometriosis-associated malignancy. Genetic alterations seem to be the cause of this condition.

Endometriosis Treatment & Care

While endometriosis is untreatable, certain therapies may improve the symptoms. Treatment & care in endometriosis oftentimes consists of painkillers, anti-inflammatory drugs and hormonal treatments, especially oral contraceptives. Surgery may be recommended in some cases.

Endometriosis & Surgery

A traditional approach to endometriosis is the surgical attempt to bring the uterus to the normal anatomy, as much as possible. By this, specialists understand the surgical removal of the adhesions that appear in the condition. The procedure is somehow complicated, because the surgeon has to remove first the endometrium and reattach it afterwards. Unfortunately, many cases, infertility may occur as a side-effect of the surgery, but not in all cases. A minimally invasive type of surgery is laparoscopy. Certain surgeons prefer a technique during which the ovaries’ activity is suspended in the post-operatory interval, with the purpose to reduce the risk of adhesion reappearance. However, regardless of the precautions, in an interval of 5 years, in more than half of the women that undergo surgery, the issue reappears.

Hysterectomy is the recommended therapy for endometriosis, for women who don’t want to get pregnant. For better results, it is recommended the combination of this surgery with endometrium removal.

Endometriosis and Hormonal Treatment

  • Oral contraceptives are used in endometriosis treatment. They are used as a long term therapy for endometriosis and they have the role to diminish or eliminate completely the pain associated with the condition.
  • Progesterone and progestin drugs are also a solution for women suffering from endometriosis. These hormones inhibit the endometrium’s growth.
  • In many cases, the treatment for endometriosis consists of suppressive steroids, such as danazol. They also have the role of reducing tissue growth.
  • Certain practitioners recommend opioids for the purpose of decreasing the pain experienced by the patient.

Living with Endometriosis

For many women, endometriosis is an agonizing disease. Unfortunately, it affects the patient’s life on all levels, from personal to professional and romantic. With excruciating pain that in some cases is persistent to anti-inflammatory drugs, many women struggle with continuous pain throughout their periods, and in some cases outside those. The disease starts showing the first signs during the teenage years. For teenage girls that experience a debilitating disease like this, it can impact the self-esteem and body image, while decreasing the appreciation towards their femininity. Nevertheless, many have learned how to live with this debilitating condition.

  • Specialists recommend visiting an OB-GYN office if someone recognizes the symptoms above in themselves.
  • Diagnosis is the first step to learning how to live with endometriosis, for many. Pain management strategies for endometriosis are oftentimes developed by medical health specialists together with the patient.
  • The treatment must be adapted to each woman, depending on the medication and therapies that seem to show effects on her.
  • For many, living with endometriosis means that they must plan their days, especially during their periods.
  • Unfortunately, for many, the issue is so severe that they lose their ability to work during certain days of the menstrual cycle. Having a medical certificate that attests the issue is a good solution for those who must take off days from work due to the condition.
  • When working, frequent breaks are recommended.
  • Women with endometriosis should always make sure that they have a medical supply kit at hand when working.
  • Endometriosis and romantic relationships – endometriosis is oftentimes preventing women from having healthy romantic relationships. Painful intercourse, bleeding during or after intercourse, general fatigue and the inability to interact with their romantic partners, their inability to sustain themselves financially, and especially some women’s inability to conceive have a negative impact on a woman’s life. Learning how to deal with it might help women tech their partners as well how to support them. In terms of emotional support, both partners must understand that the negative emotions will deteriorate the relationship, which calls for the necessity of reciprocation. Endometriosis support groups have the potential of helping both partners. Sex and intimacy are also difficult for the couples in which one partner is suffering from this condition. Because intercourse oftentimes leads to bleeding and extreme pain during intercourse for women that suffer from endometriosis, guilt may appear in both partners. The women will most likely experience guilt because of her inability to enjoy the presence of their partner, while the parent will most probably feel responsible for the pain caused to the women. However, it is important for both partners to understand that neither of them is responsible for the issue. Seeking medical help will probably ameliorate the symptoms.

Endometriosis – Conclusions

A debilitating disease, a disease that is affecting all areas of a woman’s life, endometriosis has severe symptoms usually defined by an excruciating pain. The most secure treatment method is hysterectomy, a therapy solution unfortunately unsuitable for women that want to conceive.

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