A disorder in which the tissue that forms the lining of the uterus grows outside of the uterine cavity is Endometriosis and the lining of the uterus is called the endometrium.
- When the endometrium grows on the ovaries, bowel, and tissues lining the pelvis, Endometriosis occurs.
- For endometrial tissue to spread beyond the pelvic region is unusual, but it's never impossible.
- An endometrial implant is known when endometrial tissue growing outside of the uterus.
- The area to become inflamed and painful caused by hormonal changes of the menstrual cycle affect the misplaced endometrial tissue.
Symptoms of endometriosis
There are certain symptoms which may include:
- Pelvic pain is the most common symptom of endometriosis
- Painful periods
- Pain in the lower abdomen before and during menstruation
- Cramps one or two weeks around menstruation
- Heavy menstrual bleeding or bleeding between periods
- Pain following sexual intercourse
- Discomfort with bowel movements
- Lower back pain that may occur at any time during your menstrual cycle
Causes of endometriosis
There are various causes which are as follows:
- Retrograde menstruation: Menstrual blood containing endometrial cells flows back into the pelvic cavity instead of out of the body in retrograde menstruation and these cells can stick and become thick over the period of time.
- Transformation of peritoneal cells: It is found that hormones or immune factors promote transformation of peritoneal cells, cells that line the inner side of the abdomen, into endometrial cells.
- Embryonic cell transformation: During puberty, hormones such as estrogens may transform embryonic cells into endometrial cell implants.
- Surgical scar implantation: Endometrial cells may attach to a surgical incision such as a hysterectomy or C-section, after a surgery.
- Endometrial cells transport: The blood vessels or tissue fluid system may transport endometrial cells to other parts of the body.
- Immune system disorder: Any immune system disorder may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.
Risk factors of endometriosis
There are several risk factors which include:
- Never giving birth
- Starting period at an early age
- Going through menopause at an older age
- Short menstrual cycles , for instance, less than 27 days
- Having higher levels of estrogens in the body or greater exposure to estrogens the body produces
- Low body mass index
- Alcohol consumption
- Family history of endometriosis
- Any medical condition that prevents the normal passage of menstrual flow out of the body
- Uterine abnormalities
Treatments of endometriosis
Certain treatments may be:
- Pain medication: Over-the-counter pain medications such as ibuprofen can be used to release symptoms, but it can't decrease endometriosis.
- Hormonal therapy: Taking supplemental hormones can sometimes relieve pain and stop the progression.
- Hormonal contraceptives: Hormonal contraceptives decrease fertility by preventing the monthly growth and build-up of endometrial tissue. Birth control pills, patches, and vaginal rings can reduce or even eliminate the pain in less-severe endometriosis.
- Gonadotropin-releasing hormone (GRNH) agonists and antagonists: GNRH stops the release of hormone estrogens. This prevents menstruation and creates an artificial menopause. But it can cause certain side effects such as hirsutism etc.
- Conservative surgery: It is for women who want to get pregnant or suffer from severe pain and for whom hormonal treatments are not working. Conservative surgery removes or destroys endometrial growths without damaging your reproductive organs.
- Laparoscopy: Small hole surgery, is used to both visualize, diagnose, and remove the endometrial tissue. Small incisions are made in the abdomen to remove the growths of the tissue surgically and to burn or vaporize them. Laser is commonly used for these tissues.
- Hysterectomy: It is used as a last method if the patient doesn't respond to other treatments. During a total hysterectomy, doctor will remove the uterus and cervix. Doctor can also remove the ovaries because they make estrogens and estrogens cause the growth of endometrial tissue.
Diagnosis of endometriosis
Certain diagnosis techniques are:
- A detailed family or medical history may help the doctor to rule out other issues
- Physical test of the cysts or scar behind the uterus may help the doctor to diagnose endometriosis
- Use a trans-vaginal ultrasound or an abdominal ultrasound ma be done to rule out cysts associated with endometriosis.
- Laparoscopy is the method to identify endometriosis accurately by seeing it physically through a small operation.
Fertility is the most common complication which occurs in endometriosis. About one-third to one-half of the women with endometriosis has serious issues with pregnancy. Certain IVF techniques can be their survivor.