Endometriosis is a painful medical condition that affects many women. It occurs when the endometrium (the tissue that normally lines the uterus) grows beyond the uterus and into other parts of the pelvic area. Endometriosis most commonly affects the ovaries, fallopian tubes and bowels, and the pelvic region behind the uterus. In rare cases, endometrial tissue can spread beyond the pelvis to other areas of the body.
Endometriosis is usually not a serious condition, but it can cause chronic pain and interfere with daily life. During normal menstruation, the endometrial tissue swells and bleeds, and is shed from the uterine lining. When endometrial tissue grows outside the uterine wall, it can swell and form scar tissue, causing pain and discomfort. Endometriosis can develop any time after a woman begins menstruating, but is typically seen in women in their 30s or 40s. Although some women with endometriosis experience little or no discomfort, others suffer from considerable pain and, in some cases, may experience fertility problems.
Causes of Endometriosis
While the exact cause of endometriosis is unknown, some research indicates that it may be hereditary. Women who have never had children or who experience longer than normal menstrual cycles may also be more likely to develop endometriosis. Additional causes my include the following:
- Retrograde menstruation (menstrual blood flows into fallopian tubes and pelvic cavity)
- Excessive growth of embryonic cells
- Attachment of endometrial cells to a scar after a surgical incision
Endometriosis may also be caused by an immune-system disorder that makes the body unable to detect or destroy endometrial tissue growing outside the uterus.
Symptoms of Endometriosis
In most cases, endometriosis is characterized by severe pelvic or lower-back pain, usually occurring during menstruation. Other common symptoms of endometriosis may include the following:
- Excessive menstrual bleeding
- Pain during or after sexual intercourse
- Painful urination or an increase in its frequency
- Pelvic cramping or pain that has been worsening
- Vomiting or nausea
Bowel movements may also be affected by endometriosis, and many women suffer from constipation and diarrhea.
Diagnosis of Endometriosis
Doctors often first suspect endometriosis based on the patient's symptoms. Once a medical history has been taken, a pelvic examination is performed. Diagnosis is typically confirmed through screening with an ultrasound, MRI scan or diagnostic laparoscopy, which provide internal views of the abdominal area.
Treatment for Endometriosis
Depending on a patient's symptoms, treatment for endometriosis varies. In milder cases of endometriosis, conservative methods are often effective at alleviating symptoms. Conservative methods of treatment include over-the-counter or prescription pain relievers, and birth control pills to regulate hormones. If the condition does not respond to treatment with medication, surgery to remove excess endometrial tissue may be required.
Surgery for endometriosis is usually performed through minimally invasive laparoscopy, which can thoroughly remove the endometrial tissue. Severe cases of endometriosis may require hysterectomy, which involves the removal of the uterus and cervix. This may help to eliminate the severe pain caused by endometriosis. However, a hysterectomy is typically considered a last-resort form of treatment, especially for women of childbearing age, because they will no longer be able to bear children.
There is currently no cure for endometriosis, and no certain method for its prevention. Some women find it beneficial to attend support groups with other women who suffer from endometriosis. With proper treatment and medical attention, endometriosis can be well managed.