Endometriosis occurs when cells in the lining of the uterus (womb) grow in other areas of the body. It can cause pain, heavy bleeding between periods, and possibly infertility.
Description and Symptoms
In endometriosis, the endometrial cells may be found on the ovaries, in the walls of the fallopian tubes, in the pelvic wall, or around the bowel or bladder.
The areas of endometriosis respond to changing hormones in the same way as the cells in the womb and bleeding during periods. The blood often can’t escape and can cause swelling.
The primary symptom of endometriosis is a pain in the lower abdomen during periods, although there can also be some discomfort at other times.
Periods may become heavier than usual. There is sometimes also a pain in the legs. Sexual intercourse may be painful. There may also be urinary problems or pain during bowel movements. There can be bleeding from the vagina between periods.
Fertility problems can result from endometriosis, useful if there is significant scarring around the fallopian tubes or ovaries.
The symptoms of endometriosis usually ease during pregnancy, and in most cases stop altogether during the menopause.
Every month, a woman’s ovaries produce hormones that command the lining cells of the uterus (womb) to swell and become thicker.
The uterus removes these cells along with blood and tissue through the vagina when you have the period.
Endometriosis occurs when these cells grow outside the uterus in other parts of your body. This fabric can be glued to:
- Cladding of the pelvic area
- It can also grow in other areas of the body.
These growths remain in your body, not eliminated when you have the period. But, just like the cells in the uterus, these growths react to the hormones in the ovaries.
They grow and bleed when you have the period. Over time, growths can add more tissue and blood. The accumulation of blood and tissues in the body causes pain and other symptoms.
Experts are still wondering what causes endometriosis. One idea is that when you have your period, the cells can return through the fallopian tubes to the pelvis.
Once there, they are fixed and multiplied. However, this retrograde flow of the period occurs in many women. Researchers think that the immune system in women with endometriosis can cause the condition.
Endometriosis is common. Sometimes it can be hereditary (it is passed from mothers to daughters). It probably begins when a woman starts to have periods. However, it is usually not diagnosed until 25 to 35 years of age.
Endometriosis occurs when the type of cells that line the womb (endometrial cells) are found elsewhere in the body.
The primary cause of endometriosis is believed to be retrograde menstruation, where some of the shed linings of the womb go up the fallopian tubes, rather than exiting through the vagina.
Many women have some retrograde menstruation, but it’s not clear why only some of them go on to develop endometriosis.
In some cases, endometriosis may develop from endometrial cells that have ended up in the wrong place during fetal development.
This process is known as müllerianosis; there is some controversy as to whether it is a distinct process to “normal” endometriosis.
Some studies have suggested that exposure to certain polychlorinated chemicals can increase the risk of endometriosis, although there is no scientific consensus on this issue.
People often use painkillers. They may be the only treatment needed in mild cases of endometriosis. Non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen are usually taken.
These can have side effects, such as stomach bleeding. Acetaminophen (paracetamol) is an alternative painkiller.
Contraceptive Pill: Many women find that symptoms lessen if they are taking oral contraceptives.
Some consider taking the pill to combat endometriosis, even if they don’t need to do so for contraceptive purposes.
Levonorgestrel-Releasing Intrauterine System (LNG-IUS): This contraceptive device is placed in the womb. It releases the hormone levonorgestrel. Periods become much lighter or stop altogether. This method often prevents the pain from endometriosis.
Progestin hormones are synthetic analogs of the natural hormone progesterone. Progestin tablets are often useful in combatting endometriosis.
Norethisterone and dienogest are examples of progestins used to combat endometriosis. They can lead to weight gain and other side effects.
These medicines may prevent endometriosis from getting worse. They can be given as pills, nasal spray or injections.
Only women who are not trying to get pregnant should opt for this therapy. Hormone therapy will prevent you from getting pregnant. Once you stop treatment, you can get pregnant again.
Contraceptive pills. With this therapy, you take medicines for 6 to 9 months without stopping. Taking these pills relieves most of the symptoms. However, they do not prevent healing or treat any damage that has already occurred.
Pills or injections of progesterone. This treatment helps shrink the tumors. However, side effects may include weight gain and depression.
Gonadotropin-agonist drugs. These drugs prevent the ovaries from producing the hormone estrogen. This causes a state similar to menopause.
Side effects include hot flashes, vaginal dryness, and mood swings. The treatment is usually limited to 6 months because it can weaken your bones.
Gonadotropin Releasing Hormone Agonists (GnRH Agonists) are drugs that end menstruation by reducing estrogen levels. Without hormone stimulation, the pain of endometriosis usually stops.
The effect is similar to the menopause but is reversible. Leuprorelin and buserelin are examples of these drugs.
These compounds are typically given by injection, or via a nasal spray since they are not suitable for oral dosing.
They should not be used on a long-term basis, since serious side-effects, such as bone-thinning may result.
Surgery can be effective in removing areas of endometriosis. Laparoscopic surgery (“keyhole surgery”) is often used.
A hysterectomy (removal of the womb) is sometimes carried out on women who don’t want any more children. All areas of endometriosis have to be removed for the hysterectomy to be effective.
Hormone therapy and laparoscopy can not cure endometriosis. However, in some women, these treatments can help relieve symptoms for years.
Removal of the uterus, fallopian tubes, and both ovaries (a hysterectomy) gives you the best chance of cure.