Overview

Endometriosis affects approximately 200 million women in the world, yet the condition is either misdiagnosed or missed in most cases. Lack of awareness about this disease is one of the major reasons for endometriosis that make it difficult for the condition to be detected. A lot of women end up suffering in silence because they feel ashamed to talk about their experiences with the condition.

Having a bit more understanding about endometriosis will not only help in finding better ways of treating the condition but will also make it easier for women suffering from the disease to find the courage to seek medical treatment and share their experiences.

Endometriosis is a condition in which the lining similar to that of the uterus grows outside the uterus causing pain during periods and during sex and can even cause infertility, among other health problems. The term endometriosis actually comes from the word endometrium which is the tissue that lines the uterus. The growth of endometrial tissue outside the uterus is referred to as endometrial implant.

What Causes Endometriosis?

Although the definite cause of this condition is not known, researchers have identified risk factors which include:

  • Genetic factors: Having a close family member with endometriosis can increase your risk of developing the condition as well.
  • Retrograde Menstruation: This is the process through which menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of flowing out of the body. The endometrial cells stick to the pelvic walls and organs in the pelvic region where they continue to grow and thicken and bleed over the course of each menstrual cycle.
  • Embryonic Cell Transformation: Embryonic cells are cells in their earliest stages of development. During embryonic transformation, hormones like oestrogen transform embryonic cells into endometrial-like cell implants during puberty.
  • Endometrial Cell Transport: Blood vessels or tissue fluid may transport endometrial cells to other body parts.
  • Transformation for Peritoneal Cells: Hormones or immune factors promote peritoneal cells transformation. Peritoneal cells are the cells that line the inner side of your abdomen into endometrial-like cells.
  • Immune System Disorder: Certain immune system problems can make it difficult for the body to recognize and destroy endometrial-like tissue growing outside the uterus.

Other risk factors include:

  • Starting menstruation at an early age
  • Not having given birth
  • Reaching menopause at an older age than usual
  • Short menstrual cycles less than 27 days apart or having menstrual periods that are longer than 7 days.
  • Having a low body mass index (BMI)
  • Having higher levels of oestrogen in the body or a greater lifetime exposure to oestrogen produced by your body
  • Reproductive Tract Abnormalities
  • Medical conditions that prevent normal passage of menstrual flow out of the body

Symptoms of Endometriosis

Although cramps during periods are common for a significant number of women, those with endometriosis experience menstrual pain that is worse than usual, and which may increase over time.

You should also know that the severity of your pain does not indicate the extent of your condition; a woman could experience severe pain but have mild endometriosis, and vice versa. Apart from dysmenorrhoea, other symptoms of endometriosis include:

  • Pain during bowel movements or urination
  • Pain during intercourse
  • Excessive bleeding
  • Infertility
  • Diarrhoea or constipation
  • Fatigue
  • Nausea
  • Bloating

How is Endometriosis Diagnosed?

Endometriosis can be confused with other conditions that cause pelvic pain such as ovarian cysts and pelvic inflammatory disease (PID). If you experience any signs and symptoms similar to those caused by endometriosis, ensure you see your doctor because early diagnosis can result in better management of the condition.

Here are some of the ways used to diagnose endometriosis. Diagnosis usually starts with a pelvic exam which is done to feel for any abnormalities such as cysts or scars behind the uterus.

  • Ultrasound:Using high frequency sound waves to create images of the inside of your body. This is done using a transducer which is inserted into the vagina to get images of the inside of the body. This helps the doctor to identify cysts associated with endometriosis.
  • Magnetic Resonance Imaging (MRI): This uses a magnetic field and radio waves to create detailed images of the organs and tissues within the body. It can help in surgical planning by providing the doctor with detailed information about the location and size of endometrial implants.
  • Laparoscopy: Using a laparoscope which is a thin flexible tube, to allow the surgeon to view inside the abdomen. The procedure is done while the patient is under general anaesthesia through small incisions that are made on the abdomen through which the laparoscope is inserted.

Treatment

Treatment for endometriosis depends on the severity of the symptoms and whether a woman wants to get pregnant in the future. In the beginning, conservative treatment is used after which surgery can be used if the initial treatment fails.

  • Pain medication:Pain medications like naproxen and nonsteroidal anti-inflammatory drugs are used to ease pain caused by menstrual cramps.
  • Hormone therapy: Hormone therapies used in the treatment of endometriosis include: Progestine therapy, Hormonal contraceptives, Gonadotropin-releasing hormone (Gn-RH) and Aromatase inhibitors
  • Conservative surgery: Women who are trying to get pregnant and have endometriosis, go through conservative surgery to remove the endometriosis while preserving the uterus and ovaries. Surgery can also help those with severe pain from the condition. The surgery can be done traditionally in more extensive cases or laparoscopically.
  • Fertility treatment: If you are having trouble conceiving due to endometriosis, your doctor may recommend fertility treatment which ranges from stimulating the ovaries to make more eggs to in vitro fertilization in order to find the treatment that is best for you depending on your personal situation.

Endometriosis Prevention

There are no specific ways to prevent endometriosis. However, women can reduce their risks of developing the condition by lowering their levels of hormone oestrogen in the body. This can be done by:

  • Using hormonal birth controls
  • Regular exercising to help keep a low percentage of body fat, thereby, decreasing the amount of oestrogen in the body
  • Avoiding large amounts of caffeinated drinks as that can raise oestrogen levels
  • Avoiding excessive alcohol intake
  • Not smoking
  • Eating healthy; increased omega-3 fats, avoiding trans fats, less red meat and plenty of fruits, vegetables, and whole grains

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