What is Endometriosis?
Endometriosis is a painful disorder in which tissue that normally lines ( endometrium) the uterus grows outside the uterus. This tissue can accumulate on the ovaries, fallopian tubes or intestines.
This additional growth of the endometrium works similarly to your uterine endometrium. It thickens, breaks down and bleeds during menstruation. But this external growth has no exit, it remains trapped in the pelvic region and causes inflammation and pain.
The symptoms of endometriosis are different in every female suffering from. Some women experience mild symptoms, but others may have moderate to severe symptoms. The severity of your pain does not describe the stage of the condition. You may have a mild form of the disease yet still experience excruciating pain. It is also possible to have a severe form and have very little discomfort.
About one-third of women with endometriosis remain asymptomatic. Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:
- Painful periods
- Heavy or irregular menstruation
- Lower abdomen or back pain
- Painful sexual intercourse
- Dyschezia (pain on defecation) – Often with cycles of diarrhea and constipation
- Bloating, nausea and vomiting
- Inguinal pain
- Painful urination,
- Pain during exercise
What causes endometriosis?
The exact causes of endometriosis are unclear. Several theories exist that attempt to explain the disease, although no one theory has been scientifically proven.
Major theories include the dispersal of endometrial cells that may be on your pelvic walls and the surfaces of your pelvic organs, such as your bladder, ovaries, and rectum. They continue to thicken, break down and bleed throughout your menstrual cycle in response to the hormones of your cycle.
Previous theories suggest that endometriosis results from the transport of viable endometrial cells through retrograde menstruation. The cells flow backward through the fallopian tubes and deposit on the pelvic organs, where they seed and develop.
Is endometriosis hereditary? The genetics of endometriosis
Some women may have a genetic predisposition to endometriosis. Studies have shown that first-degree relatives of women with the disease are also more likely to develop it. The search for the endometriosis gene is currently underway.
Endometriosis has four stages or types. It can be any of the following:
Stage 1: Minimal
In minimal endometriosis, there are tiny lesions or scars and shallow endometrial deposits on your ovary. There may also be inflammation in or around your pelvic pocket.
Stage 2: Mild
Mild endometriosis involves light lesions and superficial implants on an ovary and the pelvic lining.
Stage 3: Moderate
Moderate endometriosis involves thick implants on your ovary and pelvic lining. There can also be additional lesions.
Stage 4: Severe
The most severe stage of endometriosis involves thick implants on your pelvic lining and ovaries. There may also be scars on your fallopian pipes and bowels.
What are the risk factors for endometriosis?
Risk factors for endometriosis include the following:
- Family history
- Early menarche
- Short menstrual cycles (< 27 d)
- Lengthy menstrual cycle (>7 d)
- Heavy bleeding
- Inverse relationship to parity
- Delayed childbearing
- Defects in the uterus or fallopian tubes
- Iron deficiency can be a cause of early onset of endometriosis
Endometriosis dosn’t have a cure and it’s symptoms can be managed with medications and a surgical procedure is also available to help you to get pregnant.
Definitely, you want relief from pain, irregular or heavy bleeding and might be you want to get pregnant also.
It can be frustrating to go through diagnostic evaluations and medication for endometriosis. This disorder can be tough to handle mentally because of fertility problems, pain and fear of not getting a cure. Consider finding a support group or educating yourself more on the situation.
Treatment options include:
1. Pain Management
You may need over the counter pain relievers to reduce your pelvic pain while enduring this disease. You can take ibuprofen or an anti-spasmodic pill which can be a little relief.
2. Hormone Therapy
Supplemental hormones are sometimes effective in reducing or eliminating pain. The rise and fall of hormones during the menstrual cycle causes the endometrial implant to thicken, break, and bleed. Hormone medication may slow endometrial tissue growth and prevent new implantation of endometrial tissue.
3. Oral Contraceptives
Birth control pills, patches and vaginal rings help regulate the hormones responsible for building up of endometrial tissue each month. Many of the women have lighter and shorter periods when they are using hormonal contraception. The use of hormonal contraceptives can reduce or eliminate pain in some cases.
4. Gonadotropin-releasing hormone (GnRH) agonists and antagonists
These drugs block the production of ovarian-stimulating hormones, reduce estrogen levels and stop menstruation. This causes the endometrial tissue to shrink. Because these drugs create artificial menopause, taking low doses of estrogen or progestin along with Gn-RH agonists and antagonists may reduce side effects of menopause, such as hot flashes, vaginal dryness, and bone loss.
Medroxyprogesterone acetate is beneficial in pain suppression in both oral and injectable preparations. The time to resume ovulation with depot preparations is long and variable. It can have adverse effects that include weight gain, fluid retention, depression and heavy bleeding.
Danazol is as effective as any newer agent, but with a higher incidence of adverse effects. Its androgenic nature can cause oily skin, acne, weight gain, deepening of the voice, and facial hirsutism. Hypoestrogenic features due to danazol include emotional lability, hot flashes, vaginal dryness and reversible breast atrophy.
6. Conservative Surgery
Conservative surgery aims to destroy visible endometriotic implants to minimise pain and to help in pregamacy goals. The laparoscopic approach is the method of choice for the conservative treatment.
7. Last- Resort Surgery
Your doctor may recommend a rare option for total hysterectomy ( permanent removal of uterus and ovaries ) only if your condition doesn’t improve with other treatments.
Hysterectomy is not generally considered a cure for endometriosis. You will be unable to get pregnant after a hysterectomy. If you are thinking about starting a family, get a second opinion before consenting to surgery.