Endometriosis

Endometriosis: Causes, Symptoms, Diagnosis and Treatments

What is Endometriosis?

Endometriosis is an abnormality in which the tissue that forms the lining of the uterus grows outside of the uterine cavity and is one of the top three causes of infertility in women.

Under normal condition during menstrual cycle, the epithelial lining of the uterus -- called the endometrium -- begins to thicken in preparation for fertilized eggs. However, if the released eggs could not get sperm cell to fertilize it, the ’bed’ that has been well prepared for the eggs (that is, the endometrium) is thus shed during menstruation. We jokingly refer menstruation as the tears of the crying of a deprived endometrium.

In endometriosis, tissue very similar to the endometrium begins to grow outside the uterus in various parts of the reproductive system or even non-reproductive organs. It can appear in or on the ovaries, the fallopian tubes, the various structures that support the uterus, and the lining of the pelvic cavity. Sometimes, it's found in other places as well, including the cervix, vagina, rectum, bladder, bowel, and elsewhere. Such endometrium growing outside the uterus is called an endometrial implant.

The endometrial implant also responds to the levels of menstrual hormone like normal endometrial tissue -- it builds up and breaks down with the normal menstrual cycle fails to shed like normal endometrial tissue during menstruation. It only contributes to increase bleeding during menstruation. As a result, endometriosis can cause irritation, inflammation, and formation of scar tissue. If endometrial implant exists in the fallopian tube, it can thus clog the tube preventing the egg from coming in contact with the sperm cells.

Endometriomas are endometrial growths or implants formed in the ovary. they are also referred to as chocolate cysts or endometriotic cysts are a localised form of endometriosis and are usually found within the ovary. They are usually diagnosed on ultrasound.

What are the signs and symptoms of endometriosis?

While it may be nearly asymptomatic in some women, below are some of the common signs and symptoms of endometriosis :

    1. Pelvic pain

        2. Dyspareunia-Painful intercourse

    3. Dysuria-painful urination

    4. Severeabdominal pain or cramps

    5. Lower back pain

    6. Menorrhagia-heavy vaginal bleeding during menstruation

      7. General body weakness

    8. Infertility

Can I still get Pregnant after being diagnosed of endometriosis?

Endometriosis may pose great problem to a woman from getting pregnant.

Some woman got pregnant even after a confirmed case of endometriosis; it depends on the site and the severity of the endometrial implants.

 How is Endometriosis diagnosed?

Endometriosis is usually diagnosed by laparoscopy. Laparoscopy is both a diagnostic and treatment tool; it is used to visualize, diagnose and remove the endometrial implants.

It can also be diagnosed using sonography as well as MRI.

What are the treatment options for endometriosis?

Treatments include medications to suppress the symptoms and other treatment techniques.

1.         Pain medications to reduce the associated pain and the inflammations. Non-steroidal anti-inflammatory drugs called NSAIDs such as diclofenac, ibuprofen, mefenamic acid are used. These drugs are usually over-the-counter drugs.

2.         Hormonal supplements- most hormonal substances that are used as contraceptives reduces chances of pregnancy by interfering with proper preparation of the endometrium. so when used they prevent growth of endometrial implants and stop menstruation. A typical example is Depo-Provera whose active ingredient is medroxyprogesterone . A single dose of depo-provera may remain active in the body for 3months. However these types of drugs have been linked with increased incidence of osteoporosis in women.

3.         Danazol is also effective in reducing and preventing incidence of endometrial implants

4.         Surgery. This may be destructive or conservative. Laparoscopy is a conservative surgical procedure used to open and remove any endometrial implants. However in case of life-threatening endometriosis, hysterectomy can be the lasting cure. During hysterectomy, every affected organ is removed. It may involve removing the uterus, ovaries, and even the cervix. It is a complete cure and especially good for women who has passed reproductive age. It should be borne in mind that after hysterectomy, hope of any pregnancy is forfeited.