The endometrium is the tissue that lines the inner wall of the uterus. It is this tissue, which is expelled in each month during menstruation. Each month, it thickens rapidly in anticipation of a pregnancy, and if pregnancy does not occur, the excess tissue of the endometrium is then evacuated during menstruation.
In the case of endometriosis, some of these endometrial cells spread outside the uterus, usually in other parts of the . These cells respond to female hormones in the same manner as those of the endometrium. Each month, the tissue thickens, breaks down and is expelled. Unlike the cells lining the wall of the uterus, the blood and the tissues that accumulate in the abdomen do not find a way to leave the body. They then attach to other tissues and sometimes begin to divide and multiply. Sometimes they invade other tissues, or they form filaments that connect together with certain organs. They can make a scar tissue, which sometimes causes pain. A few times, the endometrial cells form a cyst, which can rupture and bleed.
This process is like a cancer, but endometriosis is not a cancerous affection. However, it may increase, but very low, the risk of developing certain cancers. Endometriosis is not a deadly disease, but it is widespread. Among women 25 to 44 years of age who are regularly menstruating, approximately 10% to 15 % suffer from endometriosis. About one-quarter to one-half of infertile women are affected by it.
You should be prepared to closely discuss with your doctor about your attempt at pregnancy.
Causes of Endometriosis
Various theories have been developed to explain endometriosis. Most appeals to the notion of retrograde flow. During menstruation, the upper layers of the endometrium are shed and are normally excreted from the body. The tissue and blood are expelled by contractions of the muscles. In some cases, however, the flow reverses and goes in the Fallopian Tubes to the ovaries. It is in this way that the endometrial cells could reach the ovaries and the pelvic cavity, areas outside of the uterus.
The retrograde flow does not explain everything, since it often appears in women who do not suffer from endometriosis. Another theory is based on disorders of the immune system. According to this thesis, the body is not able to locate or destroy the endometrial tissue found outside the uterus. There are significant differences in the immune system of women who have endometriosis, but their meaning is still unknown.
Endometriosis may have a genetic component. The daughters and sisters of women who suffer from endometriosis are at a slightly increased risk of developing this condition.
Other theories include the spread through the blood or lymph vessels and also the possibility that the healthy tissue that lines the abdominal cavity is transformed into endometrial tissue.
Symptoms and Complications
The symptoms of endometriosis include:
- Pelvic pain,
- Pain during sex,
- Changes in menstrual periods,
- The pain and cramps during menstruation,
- An emission of urine or painful bowel movements during periods,
- Infertility.
Many of these symptoms are also associated with other medical disorders. The severity of the symptoms is not necessarily related to the amount of tissue present on the outside of the uterus. Some women who suffer from endometriosis in the basin as a whole have no particular feeling, while others in whom the disorder is very limited experience excruciating pain.
Menstrual pain that has been bearable for years, but whose intensity increases, can be a sign of endometriosis.Sometimes, cysts, and scar tissue could form around the vagina and into the abdomen, thus making sexual intercourse painful. This pain can sometimes indicate a case of endometriosis, but this symptom can also be caused by other conditions. In women with endometriosis, the endometrial tissue eventually reach one of the ovaries, or even both. It may then form cysts called endométriomes.
DiagnosisThe doctor will usually start by informing them about medical history and will perform a pelvic exam. In the course of the review, it checks to see if the patient has symptoms of endometriosis and it feels then the internal organs in order to detect the presence of masses and growths. This procedure may be followed by an ultrasound of the pelvis to check for the presence of cysts in the ovaries. Often, the ultrasound does not reveal anything in particular.
If the review of the basin suggests a case of endometriosis, it can then proceed to perform a laparoscopy. In this case, a small incision is made near the navel, and a thin tube is inserted. This tube, the laparoscope, is a microscope with a light source. It allows the doctor to observe the endometriosis to the outer surface of organs in the pelvis. During laparoscopy, the doctor takes sometimes a tissue sample that will be sent to a pathologist to confirm the diagnosis. Laparoscopy can also be used to treat endometriosis, using an electric current or a laser to burn the tissue of the endometrium.
Treatment and Prevention
Endometriosis can be treated with medicines, by laparoscopic surgery or traditional surgery. The choice of treatment depends on the person and a number of factors, including the woman's age, the severity of his symptoms and his desire or not to have children.
The nonsteroidal anti-inflammatory drugs (NSAIDS), including naproxen* and ibuprofen can be used to relieve the pain. They do not, however, deal with the underlying causes of the disease. Oral contraceptives are also used. In this case, rather than take the pill for 3 consecutive weeks, followed by a stop for 1 week, the contraceptive is prescribed on a daily basis. For most women, this treatment will eventually stop menstrual bleeding. Medroxyprogesterone is sometimes used to treat endometriosis. It is usually administered as an injection. Endometriosis can also be treated with medications that regulate the menstrual cycle, causing a cessation of menstruation, which simulates the one that causes the menopause. These medications include danazol, buserelin, goserelin, leuprolide, nafarelin, and triptorelin.
A laparoscopy and a minor surgery are sometimes performed to extract the endometrial tissue in places where it should not be formed, such as the pelvis, for example. During laparoscopy, the doctor uses an electric device or a laser to burn the endometrial tissue. Laparoscopy is a technique that is less invasive than traditional surgery (e.g. Hysterectomy), and it can be done by surgery, external (without the patient is hospitalized). The growths are larger and more encapsulated sometimes require traditional surgery.
Women who do not wish to have children may opt for a hysterectomy and an oophorectomy, complete (removal of the uterus, ovaries and Fallopian Tubes). Associated with a medication, this procedure eliminates the production of female hormones and relieves therefore the symptoms associated with endometriosis. It does not, however, guarantee a relief of pain. The removal of the ovaries leads to a deficiency in estrogen. Hormone replacement therapy will be offered to women who undergo this procedure. Before accepting it, it is important to discuss with the doctor the risks and benefits of this treatment.
*All medications have both a common name (generic name) and a brand name or trademark. The brand is the appellation that a manufacturer chooses for its product (e.g., Tylenol®). The generic name is the common name international of the drug (e.g., acetaminophen). A drug can carry several brand names, but it only has a generic name. This article lists the drugs by their generic name. For more information on brand names, consult your doctor or a pharmacist.
Tags: cancer, endometriosis, health, menstrual pain, pregnancy
