An endometriotic disorder occurs when tissue of endometrium, which normally lines the inside of your uterus, grows outside your uterus. Most commonly, endometriosis affects the ovaries, fallopian tubes, and pelvic tissues. It is possible to find endometrial-like tissue beyond the region in which the pelvic organs are located on rare occasions.
Endometriosis, the endometrial-like tissue, behaves similarly to endometrial tissue, thickening, breaking down, and bleeding with each menstrual cycle. However, because this tissue cannot leave your body, it becomes trapped. Endometriomas can form when endometriosis affects the ovaries. Surrounding tissue can become irritated, leading to scars and adhesions, bands of fibrous tissue that can bind pelvic tissues and organs together.
Endometriosis can cause severe pain, especially in the menstruation. Fertility issues may also arise. Fortunately, there are effective treatments available.
signs and symptoms
Women suffering from endometriosis often experience pelvic pain during menstruation. Menstrual cramps are a common symptom of most women, but those who have endometriosis typically report far worse menstrual pain than usual. Pain may also worsen over time.
The following signs and symptoms characterize endometriosis:
- Periods of pain (dysmenorrhea). Pelvic pain and cramping can start several days before and last several days after a menstrual period. Abdominal and back pain may also be experienced.
- Intercourse causes pain. Endometriosis patients frequently experience pain during or after sex.
- Experiencing pain during bowel movements or urination. These symptoms are most likely to occur during a menstrual period.
Excessive bruising. You may have heavy menstrual periods or bleeding between periods on occasion (intermenstrual bleeding).
Infertility. Endometriosis is sometimes discovered in women seeking infertility treatment.
Other indications and symptoms
During your menstrual cycle, you may experience fatigue, diarrhea, constipation, bloating, or nausea.
Illness severity shouldn’t be based on the level of pain you experience. Depending on your level of endometriosis, you may suffer from severe pain or little pain.
Endometriosis is frequently confused with other conditions that cause pelvic pain, such as pelvic inflammatory disease or ovarian cysts. It can easily be confused with irritable bowel syndrome, which causes diarrhea, constipation, and abdominal cramping. Endometriosis can be accompanied by IBS, complicating the diagnosis.
When should you see a doctor?
Consult your doctor if you have signs and symptoms of endometriosis.
It is difficult to treat endometriosis. A better understanding of your diagnosis, early diagnosis, and a multidisciplinary medical team may lead to better symptom management.
Causes of Endometriosis
Endometriosis may have a number of root causes, some of which include:
The menstrual cycle is retrograde. During retrograde menstruation, the endometrial cells in menstrual blood return to the pelvic cavity rather than out of the body during retrograde menstruation. These endometrial cells adhere to the pelvic walls and organ surfaces, growing, thickening, and bleed throughout the menstrual cycle.
Peritoneal cell transformation. Induction theory states that hormonal or immunological factors can cause peritoneal cells – which line the inside of your abdomen – to transform into endometrial cells, which is known as the “induction theory.”
Embryonic cell differentiation. During puberty, hormones like estrogen can transform embryonic cells — cells in their early stages of development — into endometrial-like cell implants.
Scar implantation surgery. Endometrial cells might attach to a surgical incision following a procedure such as a hysterectomy or C-section.
Transport of endometrial cells. Endometrial cells may be transported to other body parts via blood vessels or the tissue fluid (lymphatic) system.
Immune system dysfunction. A problem with the immune system may prevent the body from recognizing and destroying endometrial-like tissue that develops outside the uterus.
Risk Factor of Endometriosis
You are more inclined to develop endometriosis if you have any of the following risk factors:
- Never having children
- Beginning your period at a young age
- Experiencing menopause at a later age
- Menstrual cycles that last fewer than twenty-seven days, for example, are considered short.
- Menstrual cycles lasting more than seven days
- Higher estrogen levels in your body or greater lifetime exposure to estrogen produced by your body
- Body mass index is low.
- Endometriosis is one or more relatives (mother, aunt, or sister)
- Any medical condition that prevents blood from leaving the body during menstruation.
Reproductive system disorders
Endometriosis typically manifests itself several years after menstruation begins (menarche). Unless you are taking estrogen, endometriosis symptoms may improve temporarily during pregnancy and disappear completely during menopause.
Complications in Infertility
Fertilization and implantation of an egg in the uterus
The most serious complication of endometriosis is infertility. Endometriosis prevents one-third to one-half of all women from becoming pregnant.
The egg must be released from the ovary, travel through a neighboring fallopian tube, be fertilized by a sperm cell, and attach to the uterine wall to begin development for pregnancy to occur. Endometriosis can obstruct the tube, preventing the egg and sperm from fusing. However, the condition appears to indirectly affect fertility, such as by causing sperm or egg damage.
Despite this, many women with mild to moderate endometriosis can conceive and carry a pregnancy to term. Doctors sometimes advise endometriosis patients not to postpone having children because the condition will worsen over time.
The incidence of ovarian cancer is higher than expected in endometriosis patients. However, the overall lifetime risk of ovarian cancer is already low. Endometriosis may increase that risk, according to some studies, but it remains relatively low. Although uncommon, endometriosis-associated adenocarcinoma can develop later in life in people who have had endometriosis.
Diagnosis of Endometriosis
If you have any signs of endometriosis, your doctor may suspect this condition. They can conduct tests to confirm it, such as:
Examine the cervix. Your doctor may feel cysts or scars behind your uterus.
Imaging examinations. CT scans, ultrasounds, and MRIs provide detailed images of your organs.
Laparoscopy. Laparoscopy for intraperitoneal use involves making a tiny incision in your abdomen and inserting a thin, camera-equipped tube (called a laparoscope). They can see the location and size of lesions. Typically, this is the only way to determine if you have endometriosis.
The biopsy. In order to confirm endometriosis, your doctor will take a sample of tissues, usually during a laparoscopy, and examine them under a microscope by a specialist.
Treatment of Endometriosis
Endometriosis currently has no cure, but various treatment options may help manage symptoms. They are as follows:
Relief from pain
Medications can help with pain management. Ibuprofen, Motrin, and other nonsteroidal anti-inflammatory drugs and pain relievers are among them. If over-the-counter medications do not work, a doctor may prescribe stronger medications.
A doctor may advise you to use birth control pills or other hormonal birth control methods, such as the Mirena device. They may recommend gonadotrophin-releasing hormone in some cases.
These may help to lower estrogen levels and limit the development of undesirable tissue. They cannot, however, repair adhesions or improve fertility.
If other treatments fail, a doctor may recommend surgery to remove excess tissue. In some cases, a hysterectomy involving the removal of both ovaries may be required.
In-vitro fertilization may be an option if endometriosis interferes with fertility.
It is critical to thoroughly discuss any or all of the treatments with your health care provider, as some may conflict with the efficacy of others. You can make an appointment with Dr. Morris at Moreton Bay Women’s Health.