Endometriosis

Endometriosis

Endometriosis is a painful medical condition that affects many women. It occurs when the endometrium (the tissue that normally lines the uterus) grows beyond the uterus and into other parts of the pelvic area. Endometriosis most commonly affects the ovaries, fallopian tubes and bowels and the pelvis region behind the uterus. In rare cases, endometrial tissue can spread beyond the pelvis to other areas of the body. Endometriosis is usually not a serious condition, but it can cause chronic pain and interfere with daily life. During normal menstruation, the endometrial tissues swells and bleeds and is shed from the uterine lining. When endometrial tissue grows outside the uterine wall, it can swell and form scar tissue, causing pain and discomfort. Endometriosis can develop any time after a woman begins menstruating, but is typically seen in women in their 30s or 40s. Although some woman with endometriosis experience little or no discomfort, others suffer from considerable pain and, in some cases, may experience fertility problems.

Causes of Endometriosis

While the exact cause of endometriosis is unknown, some research indicates that it may be hereditary. Women who have never had children or who experience longer than normal menstrual cycles may also be more likely to develop endometriosis. Additional causes may include the following:

  • Retrograde menstruation (menstrual blood flows into fallopian tubes and pelvic cavity)
  • Excessive growth of embryonic cells
  • Attachment of endometrial cells to a scar after a surgical incision

Endometriosis may also be caused by an immune-system disorder that makes the body unable to detect or destroy endometrial tissue growing outside the uterus.

Symptoms of Endometriosis

In most cases, endometriosis is characterized by severe pelvis or lower-back pain, usually occurring during menstruation. Other common symptoms of endometriosis may include the following:

  • Excessive menstrual bleeding
  • Pain during or after sexual intercourse
  • Painful urination or an increase in its frequency
  • Infertility
  • Pelvic cramping or pain that has been worsening
  • Vomiting or nausea
  • Exhaustion

Bowel movements may also be affected by endometriosis, and many women suffer from painful bowel movements, constipation and diarrhea.

Diagnosis of Endometriosis

Doctors often first suspect endometriosis based on the patient’s symptoms. Once a medical history has been taken, a pelvic examination is performed. Diagnosis is typically confirmed through screening with an ultrasound, MRI scan or diagnostic laparoscopy, which provide internal view of the abdominal area.

Treatment for Endometriosis

Depending on patient’s symptoms, treatment for endometriosis varies. In milder cases of endometriosis, conservative methods are often effective at alleviating symptoms. Conservative methods of treatment include over-the-counter prescriptions pain relievers, and birth control pills to regulate hormones. If the condition does not respond to treatment with medication, surgery to remove excess endometrial tissue may be required.
Surgery for endometriosis will usually thoroughly remove the endometrial tissue. Severe cases of endometriosis may require hysterectomy, which involves the removal of the uterus and cervix. This may help to eliminate the severe pain caused by endometriosis. However, a hysterectomy is typically considered a last-resort form of treatment, especially for women of childbearing age, because they will no longer be able to bear children.
There is currently no cure for endometriosis and no certain method for its prevention. Some women find it beneficial to attend support groups with other women who suffer from endometriosis. With proper treatment and medical attention, endometriosis can be well managed.

Surgery for Endometriosis

For women with moderate to severe cases of endometriosis, conservative treatment methods such as medication and hormone therapy may not be effective in relieving symptoms. These cases may require surgery to remove the excess tissue.
Surgery for endometriosis is usually performed using minimally invasive laparoscopic surgery. This utilizes tiny incisions and the assistance of a camera. Laparoscopy can often diagnose and treat endometriosis in one procedure. In fact, it is the only definitive diagnostic tool for endometriosis. As a treatment method, the excess tissue may be cut and removed or destroyed with a laser. Results are usually effective immediately but may not be permanent.
A hysterectomy can also be used to treat endometriosis by completely removing the uterus. However, the disease can still reoccur after this procedure if the tissue is not solely contained in the uterus.