Endometriosis is a condition that affects the female body and involves reproductive organs. It is a condition in which the tissue lining of the uterus, known as the endometrium, grows outside of it. It can be a very painful condition. The pelvic organs involved in endometriosis include the fallopian tubes, ovaries, and tissues that line the pelvis. The displaced endometrial lining in endometriosis acts the same way as the normal lining in the uterus, thickening before the menstrual cycle and breaking down and bleeding during menstruation. The displaced tissue, however, has no place to escape and thus can cause cysts if the ovaries are involved; this is termed as endometriomas and results in fibrous tissues that can lead to the organs sticking to each other.
Causes of endometriosis
The exact cause of endometriosis has not been ascertained, but possible causes could be retrograde menstruation in which bleeding flows from the fallopian tube back into the pelvic cavity, where the endometrial cells stick to the pelvic organs and continue to grow there. Embryonic cell transformation, peritoneal cell transformation, implantation of a surgical scar, transport of endometrial cells, and disorders of the immune system are other probable causes of endometriosis.
Symptoms and risk factors of endometriosis
The symptoms include dysmenorrhea or painful periods where the cramping and pelvic pain begins days before the period and is quite severe—worse than the pain experienced normally during menstruation. Pain is also experienced during urination, with bowel movements, and during sexual intercourse. Occasional heavy bleeding is also seen, even between menstrual cycles. Infertility is another symptom along with diarrhea, fatigue, nausea, bloating, and constipation.
The risk for endometriosis increases if a woman’s periods start at an early age, or if she has never given birth, or if menopause is at an older age, or if menstrual cycles are fewer than 27 days. Consumption of alcohol, lower BMI or body massage index, uterine abnormalities, a history of endometriosis, higher estrogen level in the body, or a medical condition that prevents the usual menstrual flow out of the body are also included as risk factors.
Endometriosis, if not treated in time, can lead to complications, such as infertility and ovarian cancer.
Diagnosis and treatment of endometriosis
To diagnose any pelvic condition, first the symptoms are investigated by the doctor, followed by a pelvic exam to check for abnormalities, including cysts in the reproductive organs. An ultrasound also helps diagnose problems in the area, especially a transvaginal ultrasound. An MRI (magnetic resonance imaging) and laparoscopy are other ways to diagnose problems with the endometrial lining and pelvic area.
The treatment depends on how far the condition has escalated, and pain medication is the first course of action to deal with the chronic pain. Further hormone therapy is also done for endometriosis, including hormonal contraceptives, Gn-RH or gonadotropin releasing hormone agonists and antagonists, aromatase inhibitors, and progestin therapy. Some patients might need conservative surgery for endometriosis or treatment for infertility; in some cases surgery might be needed to remove the ovaries, a procedure known as a hysterectomy. Lifestyle changes, alternative therapies, and support from family can also help with the treatment.