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Endometriosis

Published: 18 Dec 2023, 22:38 pm IST
Medically Reviewed by

What is Endometriosis?

The cause of endometriosis is not exactly known, but it occurs when tissue that normally lines the uterus grows outside the uterus, causing pain and a heavy menstrual cycle. If left untreated, it can aggravate and lead to complications.  

Endometriosis (en-doe-me-tree-o-sis) is a painful disease that affects individuals with a uterus or womb. In this disorder, tissue similar to the lining of the uterus, called endometrium, grows outside the uterus. This abnormal tissue growth causes severe pain in the pelvis, a heavy menstrual cycle, and makes it harder for women to get pregnant. While the exact cause remains unclear, genetic factors and immune system dysfunction are thought to play a role. Despite its prevalence, endometriosis is frequently underdiagnosed. Hence, early intervention and diagnosis can help prevent further complications related to this disease.

Causes of Endometriosis

While the exact cause of endometriosis is not exactly known, it is believed that this chronic medical condition affecting the tissue lining the uterus (endometrium) has multiple causes that can contribute to this condition. Here are some of the primary causes of it:

1. Retrograde menstruation: This theory proposes that during menstruation, menstrual blood containing endometrial cells flows backward into the pelvic cavity instead of out of the body, leading to the implantation of these cells on pelvic organs.

2. Genetic: Endometriosis often runs in families, suggesting a genetic component may play a role in the development of endometriosis and increase susceptibility.

3. Cellular metaplasia: Transformation of cells from the pelvic lining into endometrial-like cells. This abnormal conversion can result in the development of endometriosis in areas outside the uterus.

4. Endometrial cell transport: Movement of endometrial cells through blood vessels or the lymphatic system to distant parts of the body. Once transported, these cells can implant and grow, causing endometriosis.

5. Direct implantation: Surgical or medical procedures, such as C-sections or hysterectomies, may inadvertently transfer endometrial cells to areas where they can implant and proliferate.

6. Delayed childbearing: Women who have not given birth or had their first child at a later age, may be at a higher risk of developing endometriosis.

7. Menstrual irregularities: Short menstrual cycles or heavy and prolonged periods could contribute to the likelihood of endometriosis.

8. Immune system dysfunction: Certain genetic factors may influence the immune system’s ability to recognize and eliminate misplaced endometrial tissue, contributing to the development of endometriosis.

Common areas where endometriosis can form are:

  • The lining of the pelvic cavity
  • Ovaries
  • Fallopian tubes
  • Uterus
  • Bowel and bladder

Key Facts of Endometriosis

Major Symptoms

Pelvic pain
Menstrual changes
Painful menstruation
Painful intercourse
Bowel and urinary issues
Fatigue
Infertility
Gastrointestinal symptoms
Back pain
Nausea and vomiting

 

Necessary Health Tests

Medical history
Pelvic examination
Ultrasound or MRI
Laparoscopy
Biopsy

Treatment

Medical treatment

  • Painkillers (anti-inflammatory drugs)
  • Birth control pills
  • Hormonal therapies like GnRH analogues
  • Surgical intervention
  • Fertility treatments

Lifestyle modifications

  • Follow a healthy diet
  • Perform exercises regularly
  • Acupuncture
  • Regular check-ups

Symptoms of Endometriosis

With endometriosis, tissue similar to the lining of the uterus grows outside the uterus, which can be found on the ovaries, fallopian tubes, or intestines. Symptoms can vary from mild to severe. Here are some of the common symptoms of this disease:

  • Pelvic pain: Persistent pain in the pelvic region is a common symptom.
  • Menstrual changes: Irregular periods or heavy menstrual bleeding may occur.
  • Painful menstruation: You may also experience painful menstrual cramps and urination during the period cycle.
  • Painful intercourse: Discomfort or pain during sexual activity can be a symptom.
  • Bowel and urinary issues: Endometriosis may cause pain during bowel movements or urination.
  • Fatigue: Chronic fatigue or low energy levels may be associated with endometriosis.
  • Infertility: Difficulty conceiving can be a manifestation of endometriosis.
  • Gastrointestinal symptoms: Diarrhea, constipation, or bloating may be present.
  • Back pain: Discomfort in the lower back may be linked to endometriosis.
  • Nausea and vomiting: Some individuals may experience these symptoms.

Diagnosis of Endometriosis

The diagnosis of endometriosis typically involves a combination of medical history, physical examination, and various other tests.

1. Medical history: Assessing information about the patient’s menstrual cycle, pain patterns, and any relevant family history.
2. Pelvic examination: The doctor will conduct a thorough pelvic exam to identify abnormalities, tenderness, or masses that may suggest endometriosis.
3. Ultrasound: Imaging techniques such as ultrasound or MRI are done to visualize potential endometriotic lesions and assess their location and extent.
4. Laparoscopy: Laparoscopy allows direct visualization of the pelvic organs and the presence of endometriotic implants.
5. Biopsy: Collecting tissue samples during laparoscopy to confirm the presence of endometriosis and rule out other conditions with similar symptoms.

Treatment of Endometriosis

Since there is no cure for endometriosis, there are a few treatment options that help reduce pain, balance hormones and manage overall symptoms. Here are some common treatment options:

1. Painkillers

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for relieving pain and inflammation.
  • Analgesics may be prescribed for more severe pain.

2. Hormonal therapy

  • Birth control pills to regulate menstrual cycles and reduce pain.
  • Hormonal therapies like GnRH agonists suppress estrogen production.

3. Surgical intervention

  • Laparoscopic surgery to remove endometrial tissue and adhesions.
  • In some cases, hysterectomy may be recommended as a last resort.

4. Fertility treatments

  • Assisted reproductive technologies (ART) for those facing infertility.
  • Preservation of fertility options before aggressive treatments.

Other tips to manage the condition:

  • Lifestyle modifications: Performing regular exercise to manage symptoms and dietary changes, which may include an anti-inflammatory diet.
  • Therapy: Individuals with endometriosis can try acupuncture or physical therapy for pain relief. In fact, mind-body techniques like meditation and yoga can also help.
  • Monitoring and Follow-up: Regular check-ups to monitor symptoms and treatment are crucial.

Endometriosis Related FAQs

Is endometriosis curable?

Endometriosis is not currently considered curable, but various treatments aim to manage symptoms and improve quality of life.

Can I conceive with endometriosis?

Conceiving with endometriosis is possible, but it may pose challenges. Consultation with a healthcare professional is advisable for personalized guidance.

Can endometriosis damage the uterus?

Endometriosis can potentially cause damage to the uterus, impacting fertility. Early detection and management may help mitigate complications.

Why does endometriosis cause pain?

Endometriosis-related pain is often associated with the abnormal growth of tissue outside the uterus, leading to inflammation, scarring, and irritation.

Is endometriosis a sexually transmitted disease?

Endometriosis is not a sexually transmitted disease. Its exact cause is unclear, but it involves the presence of endometrial-like tissue outside the uterus.

Is endometriosis cancer?

Endometriosis is not cancer, but it shares some characteristics. Regular medical check-ups and discussions with healthcare providers are essential for accurate diagnosis and management.

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