Endometriosis
Endometriosis is a painful reproductive health condition characterized by the endometrium – the type of tissue that lines the inside of the uterus – growing outside of its normal environment. Tissue can grow on the outside of the uterus, the ovaries, fallopian tubes, and other pelvic structures.
Though the endometrium is growing in an area other than the inside of the uterus, it still behaves the same way it would if it was growing in the right place. This means that the tissue thickens, breaks apart, and bleeds during an individual’s menstrual cycle. Unfortunately, though, this tissue becomes trapped within the body because it has no readily available exit. This leads to the development of cysts, scar tissue, and adhesions on surrounding body structures.
What Causes Endometriosis?
Several conditions and factors can either cause or exacerbate endometriosis. A few of the most common causes and contributing factors include:
Embryonic Cell Transformation: Estrogen and other hormones may transform cells in their early developmental stages into endometrial-like cells.
Surgical Scar Implantation: After a surgical procedure near the pelvis, endometrial cells might attach themselves to the inside of the incision scar.
Retrograde Menstruation: This condition involves menstrual blood that contains endometrial cells flowing backward through the fallopian tubes and into the pelvic cavity. The cells then adhere to the pelvic walls and organs.
Immune Disorders: Immune disorders cause the body to mistake its own cells or become unable to recognize harmful cells. This may result in the immune system failing to destroy endometrial tissue that grows outside of the uterus.
Transformation of Cells in the Peritoneum: Hormones or immune conditions may encourage the transformation of peritoneal cells (the cells lining the inside of the abdomen) into endometrial-like cells.
Symptoms of Endometriosis
In some cases, mild cases of endometriosis may not produce very many symptoms, but in other situations, the symptoms of endometriosis can be debilitating.
Symptoms that individuals with moderate to severe endometriosis experience include the following:
Pain During Intercourse
Pain During Urination or Bowel Movements
Excessive Bleeding During Periods (including extended menstruation or bleeding between periods)
Severe Pain and Discomfort During Menstruation (cramping, pelvic pain, pain in the lower back or abdomen)
Fertility Issues (difficulty conceiving, frequent miscarriages)
Nausea and Bloating
Diarrhea or Constipation
Fatigue
Risk Factors
While endometriosis can affect practically any individual who has a uterus, there are several risk factors that may make a person more likely to develop the condition.
Risk factors for endometriosis include:
Existing Reproductive Conditions
Never Having Given Birth
Short Menstrual Cycles
Very Heavy Periods
Starting Periods at an Early Age
Late Menopause
High Estrogen Levels
Low Body Mass
Family History of Endometriosis
Treatment Options
Upon receiving a diagnosis of endometriosis, patients have a selection of treatment options to consider. Doctors and patients typically work together to determine the right treatment approach in relation to the patient’s unique needs and goals.
Pain medication is one option, usually suitable for patients with milder forms of endometriosis. Over-the-counter pain relievers like Ibuprofen or Naproxen can help relieve painful menstrual cramps.
Hormone therapy is also an avenue worth exploring, either as a way to supplement a pain relief routine or as a standalone treatment. Hormone therapy may help relieve pain brought on by endometriosis because maintaining optimal hormone levels can reduce the severity of endometrial tissue thickening and bleeding.
Hormonal options include contraceptives (birth control pills, vaginal rings, or patches), Gonadotropin-releasing agonists or antagonists, progestin therapy, or aromatase inhibitors.
Surgical Options
In more severe cases, surgery might be an option to consider, especially for patients who are hoping to become pregnant in the future. Conservative surgery aims to remove excess endometrial tissues from the individual’s reproductive organs without removing the uterus or ovaries.
This option doesn’t always produce permanent results, but may reduce pain and fertility issues for several years.
Some situations make it to where conservative surgery isn’t an option, and in those circumstances, a hysterectomy may be recommended. During this procedure, medical professionals surgically remove the uterus, and may remove the ovaries as well.
Fertility Enhancement
Individuals who want to get pregnant may also undergo fertility treatment to combat the effects of endometriosis. This treatment route may involve one of several approaches, including ovary stimulation to in vitro fertilization. Choosing the right option depends on the patient’s needs and the recommendations of the professional treating the condition.
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