Endometriosis
What
is it?
Endometriosis is a condition
in which bits of tissue from the lining of the
uterus (endometrium) grow outside the uterus. The
endometrial tissue, called an endometrial implant,
usually adheres to the pelvic organs, which
include the ovaries, uterus, fallopian tubes, the
cavity behind the uterus, and the ligaments that
support the uterus.
Endometrial implants may also adhere to the
tubes leading from the kidneys to the bladder, the
bladder, the vagina, the outer surface of the
small and large intestine, or the lining of the
chest cavity.
These locations, however, are not as
common. Because
this tissue is like the uterine lining, it bleeds
during a woman’s menstrual period in response to
the changes in hormones.
However, there is nowhere for this blood to
go, so it falls onto surrounding organs and causes
swelling and inflammation, cramps, pain, and the
formation of scar tissue.
Over time, this irritation may cause adhesions to form in the
area of the endometrial implants.
Adhesions are fibrous bands that connect
structures that are not connected normally.
Ovarian cysts may also form around the
endometrial tissue.
Who
gets it?
Endometriosis affects women
of childbearing age in the United States. It
affects anywhere from 7 to 15% of women between
the ages of 25 to 44, but can also occur in
teenagers. Endometriosis
can run in families.
A woman whose direct female relatives
(mother or sister) have endometriosis is more
likely to also have the disease.
Women who have had their first pregnancy
after the age of 30, those with an abnormally
shaped uterus, and those with menstrual periods
that last longer than one week with an interval of
less than 27 days between are more likely to have
endometriosis.
What
causes it?
A definite cause of
endometriosis has not been discovered.
Some researchers believe that, in some
women, small pieces of the uterine lining flow
backward through the fallopian tubes and into the
abdomen during the menstrual flow.
The endometrial implants then attach and
grow. Others
believe all women have some endometrial tissue
that becomes misplaced, but the immune system
destroys it.
The immune system of women who develop
endometriosis is unable to destroy the tissue.
There may also be a link between exposure
to the chemical dioxin, commonly found in weed
killers, and endometriosis.
What
are the symptoms?
Endometriosis progresses
slowly.
So, a woman may have the disease but not experience any
symptoms for years.
There is no link between the severity of
the symptoms and the severity of the disease.
Some women have great pain, but very few
endometrial implants.
Other women have severe endometriosis, but
very few or no symptoms.
The most common symptoms include pain in the lower abdomen
during the menstrual period, spotting between
periods, heavy or irregular periods, pain during
intercourse, pain during bowel movements or
urination, and lower back pain.
Many women with endometriosis experience
infertility because the endometrial implants block
the passage of the egg from the ovary to the
uterus.
How
is it diagnosed?
Your doctor may suspect
endometriosis if you have any of the above
symptoms. He
or she will perform a pelvic exam to feel for
endometrial implants.
The best way to diagnosis this disease,
however, is through a procedure called laparoscopy.
A slender viewing tube is inserted through a small incision
just below the belly button.
Your doctor can examine your internal
organs for endometrial implants and even take a
small sample of tissue (biopsy) to study under a
microscope. Your
doctor may also want you to have an ultrasound,
computed tomography scan (CT scan), or magnetic
resonance imaging (MRI) to gather additional
information.
Certain blood tests can also detect a
protein called CA125, which is found in high
levels in women with endometriosis.
Endometriosis is classified from mild to severe based on the
number and size of the endometrial implants, where
they are located and how they look, and the amount
of scar tissue and adhesions that have developed.
What
is the treatment?
Treatment of endometriosis
depends upon your symptoms, age, the extent of the
disease, and whether you plan to become pregnant. Some
forms of treatment are aimed at managing pain and
slowing the growth of endometrial tissue.
For pain relief, your doctor may prescribe aspirin and
acetaminophen or anti-inflammatory drugs, such as
ibuprofen and naproxen.
Hormonal treatments, such as oral
contraceptives, can slow the progression of
endometriosis.
However, the tissue usually begins to grow
again after treatment is stopped. The
only way to remove the tissue is through surgery.
Tissue can be removed during laparoscopy with an
electrocautery device, which uses an electrical
current to produce heat, or with a laser, which
uses a concentrated beam of light to produce heat.
Women who have the endometrial tissue
removed have a 40 to 70% rate of successful
pregnancy. However, surgical removal of
endometrial tissue is not a permanent fix.
In many cases, the tissue grows back.
The only permanent way to cure endometriosis is by removing
the uterus, ovaries, and fallopian tubes.
This procedure is only recommended in
severe cases and in women who are not planning to
become pregnant.
Once these organs are removed, the body is
forced into menopause and estrogen replacement
therapy is recommended.
Some women report success with alternative
therapies, including vitamin B complex combined
with vitamins C, E, and the minerals calcium,
magnesium, and selenium, to boost energy and fight
depression. Some
women benefit from changes in diet, including
reductions in salt, sugar, and processed foods.
Relaxation techniques, massage, creative
visualization, biofeedback, and acupuncture can be
helpful with many conditions that cause severe
pain.
Self-care
tips
Researchers have found no way
to prevent endometriosis.
Regular gynecological exams will ensure an
early diagnosis if you have any symptoms of this
disease. If
you have been diagnosed with endometriosis, follow
your doctor’s recommendations for treatment and
pain management.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
