Endometriosis: Symptoms and Treatment
Last Updated on Thursday, 18 March 2010 16:35
Endometriosis occurs when the tissue that makes up the inner lining of the uterus, the endometrium, begin to grow outside the uterus in areas such as the fallopian tubes, ovaries, the outer layer of the uterus or the lining of the pelvis.
The ovaries release eggs and produce the female hormones oestrogen and progesterone. These hormones help prepare the uterus for the implantation of a fertilized egg. At the beginning of the menstrual cycle, hormone levels increase; that signals the uterus to thicken itÃ¢â‚¬â„¢s inner lining and, making it easier for a fertilized egg to adhere to the inside of the womb.
If pregnancy does not occur hormone levels drop and the thickened lining is shed from body during menstrual bleeding.
Endometriosis occurs when the tissue that makes up the inner lining of the uterus, the endometrium, begin to grow outside the uterus in areas such as the fallopian tubes, ovaries, the outer layer of the uterus or the lining of the pelvis. The endometrial tissue outside the uterus still responds to oestrogen and progesterone, causing it to grow and thicken each month. It also results in bleeding; however there is no mechanism for the blood from the displaced endometrial tissue to be released from the body. Often the trapped blood forms cysts that develop into scar tissue and adhesions. The trapped blood also irritates the surrounding tissue, which may cause severe pain.
It is estimated that up to 40% of women with endometriosis are infertile. Some women discover they have endometriosis when seeking treatment for infertility: Infertility may occur because scar tissue and adhesions prevent the egg from leaving the ovary and moving through the fallopian tubes.
Inflammation caused by displaced uterine lining may also result in a less than ideal environment for fertilization. If pregnancy is achieved it often helps alleviate some of the symptoms of endometriosis.
The cause of endometriosis remains unclear, but there are four theories; first that endometrial cells travel backward down the fallopian tubes, adhere there and begin to grow; second that the bloodstream carries endometrial cells to locations outside of the inner lining of the uterus ; thir, that some cells in the abdomen are able to develop into endometrial cells; and finally that endometriosis is genetic and runs in families.
Endometriosis is prevented when the menstrual cycle is inhibited, for instance during pregnancy and the use of oral contraception. Women who have given birth are at a decreased risk of developing endometriosis.
The symptoms of endometriosis can range from mild to severe. In fact, some women with endometriosis have no symptoms. Other women experience pelvic pain and cramping before their period begins. This pain sometimes radiates to the lower back and abdominal area. Women with endometriosis have also reported that they experience pain during ovulation, sexual intercourse, urination and bowel movements.
Medical History: The doctor may ask questions about the location and severity of pain, as well as the time of month it is usually experienced. In addition questions about menstrual bleeding provide valuable information during the diagnosis process.
Physical examination: During a pelvic exam the doctor will look for cysts and scar tissue that may be located on the reproductive organs.
Trans-vaginal Ultrasound: Images of the reproductive organs are produced that may indicate the presence of cysts adhesions and scar tissue. During this procedure a thin cylindrical device is inserted into the vagina. The device produces sound waves that are analysed by a computer to provide images.
Laparoscopy: A laparoscope, a slender tube with a camera on one end is inserted into the pelvic area through a small incision. The surgeon uses this device to look for damage to the reproductive organs that may have been caused by endometriosis.