Endometriosis occurs when the tissue lining the inside of the uterus spreads to the outside, often attaching to the ovaries, fallopian tubes, the uterus’ outer surface, the pelvic cavity’s lining, or other parts of the lower abdomen. These small pieces of misplaced tissue are sometimes called endometrial lesions or implants. The cause of endometriosis, which occurs only in menstruating women, is unclear.
The misplaced endometrial tissue still responds to a woman’s monthly cycle – the tissue builds up, breaks down, and bleeds. But unlike the tissue and fluids within the uterus, which are expelled during menstruation, the tissue from endometriosis has no place to go. The result can be inflammation and scar tissue formation around the locations of the endometrial implants.
What is endometriosis?
Symptoms of endometriosis
Symptoms of endometriosis may include pain, infertility, and abnormal menstrual bleeding. Related pain, which might occur at different points in the menstrual cycle, can be severe. However, some women with even severe endometriosis may not experience discomfort.
Accurate diagnosis of endometriosis is important regardless of pain severity. Even mild cases of endometriosis can affect fertility due to organ damage, embryo implantation problems, increased white blood cells within the abdominal area, and stress on the immune system.While pelvic or ultrasound exams may suggest endometriosis, the only way to definitively diagnosis the disease is with direct inspection via laparoscopy. A laparascope is a long, thin, lighted, flexible, telescope-like instrument, inserted through a small surgical incision just below the navel. The surgeon can then view and treat, if necessary, endometriosis or other pelvic conditions.
Treatment of endometriosis
Treatment of endometriosis may include hormone therapy or surgery.
For mild or moderate endometriosis pain, nonprescription pain relievers (aspirin, acetaminophen, or ibuprofen) may be helpful. If these don’t provide relief or if pain is severe, a prescription pain medication may be needed. Some women have found additional relief using acupuncture, biofeedback, meditation, and exercise.
Hormone therapy includes the use of oral contraceptives (estrogen, progestins, or both), danazol, or GnRH agonists. These medications work by stopping ovulation temporarily. This can help shrink the endometrial lesions and stop the development of new implants. But hormone therapy does not cure endometriosis – the disease recurs in most women when hormone therapy stops.
Surgical treatment removes endometrial implants and scar tissue by cutting away, cauterizing (burning), or vaporizing with a laser. Surgical treatment can usually be done during the laparoscopic inspection. If endometriosis is severe or if the implants cannot be reached easily with the laparoscope, more extensive surgery – laparotomy – may be beneficial. Laparotomy requires a larger incision of about four to five inches.Hormone therapy and/or surgery to remove endometrial implants may help to relieve symptoms temporarily and may make it possible to conceive. Some women with severe endometriosis may consider hysterectomy and removal of the ovaries.
Research is ongoing to determine the causes of endometriosis. For now, many believe that three possible sources increase chances of endometriosis: genetics, immunological disorders, and exposure to the environmental contaminants dioxin or organochlorine. In addition to regular medical care, you can take two steps for self care: stay informed, and, if the disease is causing ongoing problems and struggle, seek the support of other women who are going through the same experiences.
The Endometriosis Association, a non-profit, self-help organization for women with endometriosis, provides information and promotes research about the condition. Chapters located throughout the United States and Canada are local resources for information and support.
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