Endometriosis occurs when endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body.

As the tissue continues to thicken, break down, respond to menstrual cycle hormones and bleed during the menstrual cycle, endometriosis forms deep inside the body.

Scar tissue and adhesions form and this can cause organ fusion and anatomical changes.

Endometrial tissue consists of gland, blood cells and connective tissue.  This normally grows in the uterus to prepare the lining of the womb for ovulation.  They can develop anywhere in the body but they usually occur in the pelvic area.  They usually affect:

  • The ovaries
  • The fallopian tubes
  • The peritoneum
  • The lymph nodes

This tissue is normally expelled during menstruation but displaced tissue cannot do this.  This leads to physical symptoms such as pain.  As the lesions grow larger they can affect bodily functions e.g. fallopian tubes may become blocked.

SYMPTOMS

 Symptoms of endometriosis include:

  • Severe menstrual cramps
  • Long tern lower back and pelvic pain
  • Periods lasting longer than 7 days
  • Heavy menstrual bleeding where the pad or tampons needs to be changed every 1 to 2 hours
  • Bowel and urinary problems including pain, diarrhoea, constipation and bloating
  • Bloody stools or urine
  • Nausea and vomiting
  • Fatigue
  • Pain during intercourse
  • Spotting or bleeding between periods

COMPLICATIONS OF ENDOMETRIOSIS INCLUDE THE FOLLOWING:

  • Infertility
  • Increased risk of developing ovarian cancer or endometriosis associated adenocarcinoma
  • Ovarian cysts
  • Inflammation
  • Scar tissue and adhesion development
  • Intestinal and bladder complications

TREATMENT

 Treatment options available are:

Pain Medications

Over the counter non-steroidal anti-inflammtory drugs (NSAIDs)

Hormones

Treatment may be with hormonal therapies such as birth control, Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, Medroxyprogesterone (Depo-Provera).  The placement of an intrauterine device (IUD) may also  be used.

Surgery

Initial surgery will seek to remove the areas of endometriosis, but a hysterectomy with removal of both ovaries is a last resort.

DIAGNOSING ENDOMETRIOSIS

 The only way to truly confirm this condition is by undergoing a surgical laparoscopy.  A surgical laparoscopy is a minimally invasive procedure in which a thin, lighted tube with a miniature camera attached (called a laproscope) is inserted through a small incision in the pelvic area.

CAUSES

Possible causes include:

Problems with menstrual flow

Menstrual blood enters the fallopian tubes and the pelvis instead of leaving the body in the usual way.

Embryonic cell growth

Embryonic cells lining the abdomen and pelvis develop into endometrial tissue with those cavities.

Endometrial cell transport

The lymphatic system transports endometrial cells to various parts of the body.

Genetics

There may be an inherited component.  A woman with a close family member who has endometriosis is more likely to develop endometriosis herself.

Hormones

Endometriosis is stimulated by the hormone oestrogen.

Immune System

Problems with the immune system can prevent the destruction of extra uterine endometrial tissue.

Endometriosis can make it hard to get pregnant.  It may happen if the tissue growing outside the uterus causes scarring, which can affect your fallopian tubes and keep an egg and sperm from meeting.  It can also stop a fertilized egg from implanting in the lining of the uterus.  Surgery can remove the extra tissue, which may make it easier to get pregnant.  Or you may decide to look into assisted reproductive techniques (ART) such as in IVF (in-vitro fertilization) to help conceive.

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