Endometriosis : Causes and Symptoms
Endometriosis is disease that occurs when endometrial tissue grows outside the uterus. Endometrial tissue is a tissue that normally grows on the uterus inner side in preparation of the womb for ovulation. Endometrial tissue consists of connective tissue, glands, and blood vessels. When endometrial tissue grows in other body parts rather than the uterus, the condition is known as endometriosis.
Even though the endometrial tissue grows outside, it still acts as it should during menstrual cycles. This means at the end of your menstrual cycle, the tissue will break and bleed as it normally does in the uterus. However, the blood coming from endometrial implants will have nowhere to go. This blood makes surrounding tissues swollen and inflamed, and scar tissue may develop. The most common site for endometriosis is the pelvic area and it may affect tissues such as:
Ovaries are affected most. As it normally occurs in menstrual cycles, this tissue is shed, but the replaced tissue cannot do so.
Doctors and scientists have not identified the exact cause of endometriosis. However, some experts suggest that the condition is caused by the following:
Retrograde menstruation- - This is a condition where the menstrual blood flows through the fallopian tubes and the pelvis and embeds itself on the pelvic organs, instead of leaving the body the usual way.
Genetics- Research shows that this condition tends to run in families and affects some ethnic groups more than others. This suggests that there is an inherited component that makes one susceptible to endometriosis
Immune system- Problems with the body’s immune system can alter the destruction and shedding off of endometrial tissue.
Surgical scar implantation- Endometrial cells may attach themselves to a surgical incision after surgeries such as C-section and hysterectomy.
Embryonic cell growth- Female hormones such as estrogen may lead to transformation of embryonic cells during their early stages of development. Such cells may become endometrial implants during puberty.
Peritoneal cell transformation-Experts suggest that immune factors and hormones may promote the growth transformation of peritoneal cells into endometrial cells.
Fetal development- Research shows that endometrial implants can be found in a developing fetus but this has been linked to pubertal estrogen.
Factors that can increase your risk of endometriosis development include:
Abnormalities with the uterine
Any underlying medical condition such as uterine or cervix cancer that may prevent normal menstrual flow.
Greater exposure to estrogen or higher levels of estrogen in the body
Menstrual periods at early age
Never getting pregnant or giving birth.
The primary sign of endometriosis is pelvic pain that is usually associated with menstrual periods. Though many women experience cramping during their periods, those who have endometriosis describe their menstrual pain worse than usual. Common signs and symptoms of endometriosis include:
Painful periods(Dysmenorrhea)- This is a condition where pelvic pain begin before the menstrual period and even extend for some days into and after the period. You may as well experience abdominal pain and lower back pain.
Pain during sex- Endometriosis is associated with pain during intercourse or after.
Excessive bleeding- When you have endometriosis you may have heavy periods and bleeding in between periods.
Infertility- Infertility may be one sign you have endometriosis. Statistics shows that 20 to 40 percent of infertile women have endometriosis.
Vaginal bleeding after sex
Other signs of endometriosis include:
Pain during urination and bowel movements
Such symptoms are usually experienced during your periods.
Severity of the symptoms cannot be a reliable indicator of the extent of endometriosis. Some women may experience intense pain with mild endometriosis, while others may experience little pain with advanced endometriosis.
Endometriosis may be confused or mistaken with other sources of pelvic pain. Other Sources of pelvic pain include:
Chronic pelvic inflammatory disease
Pelvic congestion factors
Interstitial cystitis also known as painful bladder syndrome.
Endometriosis has 4 stages namely minimal, mild, moderate and severe. Several factors may determine the stage of the condition. Such factors may include the size, location, number and the depth of the endometrial implants.
Stage 1: Minimal :- In this condition, there are small wounds or lesions and swallow endometrial implants on the ovary. This stage is also characterized by inflamed pelvic cavity.
Stage 2: MildIn this stage, there are shallow endometrial implants and light lesions located on the ovary and pelvic cavity or lining.
Stage 3: ModerateThis stage is characterized by several lesions and deep implants on the ovary and pelvic lining.
Stage 4: SevereThis is considered the worst stage of endometriosis. It is associated with deep implants on the ovaries and pelvic lining. At this stage, lesions can be found in the bowels and fallopian tubes.
Diagnosing and Treating the Disease
Before treating your pelvic pain, it is important to have a detailed and accurate diagnosis since the signs of endometriosis are similar to those of other conditions such as irritable bowel disease, ovarian cysts and painful bladder syndrome. Your doctor may therefore consider performing one or more of the following tests:
Detailed history:- Your symptoms will be examined followed by assessment of family history of endometriosis. Health assessment may be needed to help determine other signs of long-term endometriosis.
Physical examination:- This is a pelvic examination that is done manually feel any scars or cysts around the uterus.
Laparoscopy:- This is a diagnosis method where endometriosis can be identified by viewing directly using a laparoscope.
Ultrasound:- Your doctor may use an abdominal ultrasound or a transvaginal ultrasound to provide images of your reproductive tissues and organs. This can help your doctor rule out other causes of pelvic pain such as ovarian cysts. After accurate diagnosis of endometriosis, your doctor may choose the best treatment method depending on the severity of symptoms and whether you would like to become pregnant. Treatments for this condition are usually surgery or medications.
Treatment approaches for endometriosis include:
Pain medications:- They include over the counter NSAIDs such as ibuprofen, paracetamol and other prescription drugs to treat painful menses.
Hormonal medications:- They are usually used to reduce pain and balance hormones during menstrual cycles. They include:
Gonadotropin releasing hormone agonists and antagonistso
Surgery:- Surgery may be needed to remove endometrial implants. Hysterectomy may be needed to remove the uterus and ovaries in severe cases of endometriosis.
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