Reproductive system Women's Health

Endometriosis Cause Symptoms Diagnosis Treatment

June 21, 2023
drprit

Endometriosis is a chronic and often painful disorder in which tissue similar to the lining of the uterus, called endometrium, grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, outer surface of the uterus, and other pelvic organs. In rare cases, it may spread beyond the pelvic region. Endometriosis affects an estimated 10% of women of reproductive age, typically between the ages of 25 and 40, but it can occur in girls as young as their teenage years.

Thank you for reading this post, don't forget to subscribe!

Causes:

The exact cause of endometriosis is unknown, but several theories exist:

  1. Retrograde menstruation: This theory suggests that during menstruation, some of the menstrual blood flows backward through the fallopian tubes and into the pelvic cavity, allowing the endometrial tissue to implant and grow.

  2. Embryonic cell transformation: It proposes that certain cells outside the uterus can transform into endometrial-like cells and grow in abnormal locations.

  3. Surgical scar implantation: Following surgeries such as a C-section or hysterectomy, endometrial cells may attach to the incision site and develop into endometriosis.

  4. Hormonal factors: Hormones such as estrogen may influence the growth and behavior of endometrial tissue, contributing to endometriosis.

Symptoms:

The severity of symptoms can vary widely among individuals. Some women may have mild symptoms or be asymptomatic, while others experience severe pain and fertility issues. Common symptoms of endometriosis include:

  1. Pelvic pain: This is the most common symptom and can range from mild to debilitating. The pain may occur before or during menstruation, during sexual intercourse, or during bowel movements or urination.

  2. Menstrual irregularities: Some women with endometriosis experience heavy or prolonged menstrual bleeding, while others may have irregular periods.

  3. Painful intercourse: Pain during or after sexual intercourse, known as dyspareunia, is a common symptom of endometriosis.

  4. Chronic pelvic pain: Persistent pain in the pelvic region, not necessarily linked to the menstrual cycle, is another characteristic symptom.

  5. Infertility: Approximately 30-40% of women with endometriosis may experience difficulties getting pregnant due to factors such as distorted anatomy, adhesions, or hormonal imbalances.

Diagnosis:

The diagnosis of endometriosis typically involves a combination of the following steps:

  1. Medical History Evaluation: Your healthcare provider will begin by discussing your symptoms, menstrual history, and any family history of endometriosis or other related conditions. They may ask questions about the nature, severity, and timing of your pain or other symptoms.

  2. Physical Examination: A pelvic exam may be conduct to check for any abnormalities, tenderness, or masses in the pelvic region. However, it’s important to note that endometriosis lesions are not always detectable during a pelvic exam.

  3. Imaging Tests: While imaging tests cannot definitively diagnose endometriosis, they may be used to rule out other conditions or detect possible signs of endometriosis. These tests may include:

    • Ultrasound: Both transvaginal and abdominal ultrasound scans may be performed to visualize the reproductive organs and check for the presence of ovarian cysts, which can be suggestive of endometriosis. However, it’s important to note that ultrasound cannot diagnose endometriosis with certainty.

    • Magnetic Resonance Imaging (MRI): An MRI scan may be ordered to create detailed images of the pelvic region. MRI can provide better visualization of structures and potential endometriotic implants, particularly in deep infiltrating endometriosis cases.

  4. Diagnostic Laparoscopy: Laparoscopy is the gold standard for diagnosing endometriosis. It is a minimally invasive surgical procedure performing under general anesthesia. Laparoscopy involves making a small abdominal incision and inserting a narrow, illuminated laparoscope to view the pelvic organs. To biopsy endometriotic lesions, further incisions may be done.

    The surgical findings, including the location, size, and appearance of endometriotic lesions, are used to confirm the diagnosis of endometriosis.

Treatment:

Treatment options for endometriosis aim to relieve pain, control the progression of the disease, and improve fertility if desired. They include:

  1. Pain medication: Over-the-counter pain relievers like ibuprofen or prescription-strength drugs can help manage pain.

  2. Hormonal therapies: These include hormonal contraceptives (birth control pills, patches, or vaginal rings), gonadotropin-releasing hormone (GnRH) agonists, progestins, and danazol. These treatments can help suppress the growth of endometrial tissue and reduce symptoms.

  3. Surgery: Laparoscopic surgery can be using for both for diagnosis and to remove endometrial implants and scar tissue. In severe cases, a hysterectomy with removal of the ovaries and fallopian tubes may be recommending.

  4. Assisted reproductive technologies (ART): In cases where infertility is a concern, techniques like in vitro fertilization (IVF) may be used to help achieve pregnancy.

Lifestyle modifications, such as regular exercise, a healthy diet, and stress management.

Read more...