Endometriosis Endometriosis is the abnormal growth of endometrial tissue similar to that which lines the interior of the uterus, but in a location outside of the uterus. Endometrial tissue is shed each month during menstruation. Areas of endometrial tissue found in ectopic locations are called endometrial implants. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity. They are less commonly found to involve the vagina, cervix, and bladder. Rarely, endometriosis can occur outside the pelvis. Endometriosis has been found in the liver, brain, lung, and old surgical scars. Endometrial implants, while they may become problematic, are usually benign. Symptoms Other medical conditions such as pelvic inflammatory disease, ovarian cysts, and irritable bowel syndrome can mimic the symptoms of endometriosis.Symptoms of endometriosis include: ●Severe menstrual cramps, unrelieved with NSAIDS ●Long-term lower-back and pelvic pain ●Periods lasting longer than 7 days ●Heavy menstrual bleeding where the pad or tampon needs changing every 1 to 2 hours ●Bowel and urinary problems including pain, diarrhea, constipation, and bloating ●Bloody stool or urine ●Fatigue ●Pain during intercourse Pain is the most common indication of endometriosis, but the severity of the pain does not always correlate with the extent of the disease.Pain often resolves after menopause, when the
body stops producing estrogen production. However, if hormone therapy is used during menopause, symptoms may persist.Pregnancy may provide temporary relief from symptoms. Causes Although the exact cause of endometriosis is not certain, possible explanations include: ●Retrograde
menstruation. In
retrograde
menstruation,
menstrual
blood
containing
endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle. ●Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells. ●Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty. Treatment Treatment for endometriosis is usually with medications or surgery. The approach you and your doctor choose depends on the severity of your signs and symptoms and whether you hope to become pregnant. Generally, doctors recommend trying conservative treatment approaches first, choosing surgery as a last option. Diagnosis Endometriosis is most commonly treated by obstetrician-gynecologists. Endometriosis can be suspected based on symptoms of pelvic pain and findings during physical examinations. Occasionally, during a rectovaginal exam (one finger in the vagina and one finger in the rectum), the doctor can feel nodules (endometrial implants) behind the uterus and along the ligaments that attach to the pelvic wall. At other times, no nodules are felt, but the examination
itself causes unusual pain or discomfort. Unfortunately, neither the symptoms nor the physical examinations can be relied upon to conclusively establish the diagnosis of endometriosis Exercise, such as walking, may reduce pain and slow the progress of the condition by reducing estrogen levels. It is important to spot symptoms on time, because of the long-term complications of endometriosis. Intolerable pain or unexpected bleeding should be immediately reported to a doctor. Although there is currently no cure for endometriosis, most women are able to relieve the pain and will still be able to have children.