Endometriosis

What is endometriosis?

Endometriosis is a condition in which endometrial tissue is present in the body in areas other than the uterine cavity, for example in the ovaries, in abdominal organs, like bladder, guts, post-surgical scar, etc. It is more common in menstruating women between the ages of 30-40.

What happens to the abnormal tissue?

The implanted endometrial tissue responds to hormones, just like the normal physiological endometrium, the internal lining of the uterus. It grows and shreds according to menstrual cycle changes. But these shreds are not removed from the site of pathological tissue, which leads to their storage and development of cysts filled with blood and pieces of tissue. If these are large, they may cause a pressure on the surrounding organs.

What are the causes of endometriosis?

It is not known exactly how the endometrial tissue reaches other parts of the body. One theory is called retrograde, or backward, menstruation. Normally during menstruation, portions of the sloughed-off uterine lining are removed from the uterus through the cervix and the vagina. But in retrograde menstruation, fragments of the endometrium flow back into the fallopian tubes and may then enter the abdominal cavity, giving rise to endometriosis. In rare cases, where endometrial tissue is found in the lungs, it has been speculated that stray endometrial fragments travel through the bloodstream or the lymphatic system. Researchers have also said that people with endometriosis may have a defect in their immune system. Certain cells have also been attributed with the ability to change into endometrial cells.

What are the symptoms of endometriosis?

The symptoms of endometriosis are:

Perimenstrual pains, which may develop 2-4 days before menstrual flow and continue through the bleeding period Secondary aches of this kind develop gradually from puberty and more usually around the age of 20-30, they are not present from the very first menstruation. Excessive menstrual bleeding, which is often prolonged. Pain in the lower part of abdomen, which occur between menses. Irregular bleeding, blood stains in between menstruations. Pain in the upper back area of the vagina during intercourse, and passing a stool.

How is endometriosis diagnosed?

A doctor will diagnose this condition based on the presence of typical symptoms, gynecological exam and an ultrasound scan. Examining the suspected tissue under a microscope can help the doctor arrive at a definitive diagnosis.

What is the treatment for endometriosis?

Treatment of endometriosis depends on the size of the tissue involved, the age of the patient and her desire to preserve fertility. Surgical removal of the ectopic tissue is often done by laproscopy, a method by which a special device is used to enter the abdomen through a tiny cut. But if endometriosis has spread to distant organs, then classical surgery may be necessary. Hormones may be as part of the treatment, after incomplete surgical removal, or recurrence. Hormonal treatment can also be useful in some situations, such as temporarily controlling pain or preparing a woman for surgery.

What are the complications of this condition?

Endometriosis may cause many complications like infertility, ectopic pregnancy (for example the fetus may develop in the fallopian tube). Most of the time, women regain their fertility if adequate treatment is given.

Can a woman conceive even if the endometriosis has not been treated?

Endometriosis has been identified as a major cause of infertility, but some women with endometriosis may conceive without removal of the abnormal tissue.

Does a person with endometriosis have a greater chance of developing ovarian cancer?

No. It has not been proved that endometriosis is associated with increased risk of ovarian cancer.

Will a person with advanced endometriosis need hysterectomy?

Surgery, along with medical treatments will often prevent the need for hysterectomy.