WHAT IS ENDOMETRIOSIS?
Endometriosis gets its name from the word endometrium, the tissue that lines the uterus (womb). Tissue that looks and acts like the lining of the uterus grows outside the uterus in other areas. These patches of endometriosis can be called growths, implants, lesions, or nodules.
Endometriosis is divided into four stages, stage 1 (least severe) to stage 4 (most severe).
Most endometriosis is found:
- behind the uterus
- on the tissues that hold the uterus in place
- on the bowels or bladder
- on or under the ovaries
Endometriosis is commonly found in the pelvis and is a condition where cells similar to those found lining the womb (uterus) are found in other parts of the body. Besides the pelvis, which includes inside or on the ovaries, behind the uterus and on the bowel and bladder, endometriosis can also be found in the lungs, chest cavity, abdominal wall scars, the navel and elsewhere in the body.
Each month that a woman is not pregnant, the uterus lining breaks down and becomes a menstrual period. The endometriosis tissue goes through a similar cycle during menstruation. This usually causes pain during periods, inflammation and scarring and can cause organs or structures to stick to each other and can lead to distortion of the normal anatomy.
The Pain caused by endometriosis affects patients, family, friends and society.
CAUSES OF ENDOMETRIOSIS
Current theories of origin include:
Genetic Cause: Endometriosis is very likely a genetic disease. It is already known that endometriosis can run in families. the genetic basis of endometriosis is being actively researched, but gene therapy may be possible in the future.
Metaplasia: the process of cells changing from one type of benign tissue into another type of benign tissue. Cells occurring in embryologically determined patterns and which line the pelvic cavity may change into endometriosis under proper conditions.
Embyronic rests: during embryonic formation of the uterus, problems with differentiation and migration of cells results in small islands of endometriosis deposited in embryologically determined patterns in the pelvis. This process is also associated with metaplasia.
Retrograde menstruation: during menstruation, some of the menstrual blood gets pushed up and out of the fallopian tubes. The blood carries tissue bits or individual cells of the endometrial lining. these cells then fall down upon the pelvic surfaces, where, like seeds falling upon fertile soil, they allegedly attach, invade and proliferate into endometriosis. Direct evidence supporting all facets of this theory has not been presented.
SYMPTOMS OF ENDOMETRIOSIS
Approximately 10% of women suffer from endometriosis. While some women may have no obvious symptoms or signs of the disease, many will have one or more of the following:
Pain passing urine and/or stool
Pain during sex
Pelvic pain not associated with a menstrual period
Sense od abdominal bloating or heaviness
Painful periods are common in women with endometriosis, although painful periods may be coming from the uterus, not from endometriosis.
WHY DOES ENDOMETRIOSIS CAUSE PROBLEMS?
Endometriosis is composed of glands surrounded by a tissue called stroma. The glands secrete an unknown substance that leaches through tissue to irritate adjacent nerves, destabilise nearby capillaries,, with inflammation, pain and scar tissue the possible results.
Adhesions are a form of scar tissue that can form in response to the inflammation caused by endometriosis. Adhesions glue organs together so movement and stretching can cause pain. Adhesions can be related to infertility and bowel problems. When problematic, adhesions require surgery for treatment.
Adhesions are a normal part of the wound-healing process and do not always lead to problems.
Ovarian endometriosis can develop from inside the ovaries or develop on its surface. An endometrioma is an ovarian cyst with endometriosis in its lining. Endometriomas are often filled with bloody fluid and cause pain by cyst growth and pressure on the surrounding structures. Endometrioma cysts rarely occur without endometriosis elsewhere in the pelvis.
Endometrioma cysts signify an increased risk of invasive endometriosis and of intestinal endometriosis.
Endometriosis can invade bowel, bladder, ureters, vagina and diaphragm and directly inflame and irritate the organ which is invaded. this leads to organ-specific symptoms such as painful bowel movements, bloody and painful urination, vaginal spotting and right chest and shoulder pain.
● Endometriosis affects 10% of women.
● 40% of women with infertility have endometriosis.
● Surgical removal of even mild endometriosis has been shown to improve a woman's chances of getting pregnant.
● Women with untreated endometriosis are more likely to suffer a miscarriage.
● Endometriosis is often present for many years before the diagnosis is made.
● When women are cared for by expert surgeons, repeat operations are required less frequently.
● Endometriosis is cured by pregnancy.
● All women with endometriosis have pain.
● Laparoscopic surgery is required every six months 'just in case' the condition has recurred.
● Ovaries containing endometriosis should always be removed.
● Drug treatment for endometriosis cures endometriosis.
● A hysterectomy is the best treatment for endometriosis.
COMMON ENDOMETRIOSIS SYMPTOMS
Painful intercourse with deep penetration
Non-menstrual pelvic pain
Abdominal discomfort and fullness
Rectal pain with bowel movements
Bladder pain or bleeding with urination
Spotting between menstrual flows
Irregular or heavy periods, painful periods and low back pain are common in women with endometriosis but may be caused by the uterus rather than by endometriosis.