Endometriosis

Endometriosis is one of the most common gynecological diseases and can affect any woman from the time of her first period to menopause. It is a disease in which bits of tissue from the lining of the uterus pass through the fallopian tubes and attach to the ovaries, pelvis, bladder or other areas in the abdomen. During a normal menstrual cycle, the lining of the uterus, or endometrium, becomes thicker because of stimulation by hormones. If a pregnancy does not occur, the endometrium sheds the material it produced, causing the menstrual flow or period. For most women, this occurs every month. The endometrium growing outside the uterus also goes through a similar cycle and sheds tissue. The flow from the endometrial tissue that is in the abdominal cavity cannot leave the body, however. Over time, in the process of going through this monthly cycle, the blood and tissue from endometrial tissue outside the uterus can irritate surrounding organs and tissues. It can lead to nodules or bumps on the surface of pelvic organs, or become cysts in the ovaries. Scar tissue and adhesions can develop, causing pain and, possibly, problems with fertility. It is one of the top three causes of infertility in women.

Causes

The cause of endometriosis is unknown. Certain risk factors make a woman more prone to having the disease. Women with a mother, sister or daughter who has endometriosis are 10 times more likely to have endometriosis than women without an effected relative. In rare cases, it can be caused by a medical problem called hematocolpos, in which the hymen prevents the normal passage of menstrual flow. Some studies also show that previous infections in the pelvis can damage the cells that line the fallopian tubes and lead to endometriosis. Uterine anomalies are other potential causes of endometriosis. 

Symptoms

Although endometriosis does not always have symptoms, these are some common warning signs:

• Painful periods. Pelvic pain and cramping begin before a period and last until several days afterward. Endometriosis may also involve pain in the lower abdomen and lower back.

• Heavy periods or bleeding between periods.

• Pain during ovulation.

• Sharp pain deep in the pelvis during intercourse.

• Painful bowel movements or urination during menstrual periods.

Symptoms may be mild at the beginning, but tend to become worse. Endometriosis can cause fertility problems if it is not treated. In fact, for some women, endometriosis is not diagnosed until they seek treatment for infertility.

Because the cause of endometriosis is unknown, it is difficult to prevent the disease. Women who have had children appear to be less likely to develop the disorder.

Endometriosis is usually diagnosed by ultrasound or magnetic resonance imaging. These produce a “picture” of the inside of the body, which allows endometriosis areas to be identified. The only way to know for sure that you have the condition is by having laparoscopy surgery, in which a doctor can look into the abdomen and find endometriosis.

Treatment

• Pain medications. Over-the-counter pain relievers can relieve the menstrual pain that endometriosis causes. If you find that you are taking more than the regular dosage, you may need to try another treatment.

• Hormone therapy. The rise and fall of hormones during a woman's menstrual cycle cause the endometrial tissue to thicken, break down and bleed. Taking hormones or other medications that decrease the production of estrogen and progestin can help shrink the tissue or prevent it from building up, which can help lessen the pain.

• Surgery to remove scar and endometrial tissue outside the uterus.

• Hysterectomy. In severe cases, the best treatment for endometriosis may be a hysterectomy. During this surgical procedure, some or all of a woman's reproductive organs are removed. This operation is a last resort, particularly for women in their childbearing years. A woman who has had a hysterectomy cannot get pregnant.

Self-Care Steps for Endometriosis

Endometriosis can be a frustrating disorder if it remains untreated. The pain that often accompanies it can cause missed school or work days. As it continues, the discomfort can cause depression, irritability, anxiety and anger. If you are trying to have children and cannot, endometriosis can cause feelings of helplessness.

If you are dealing with the symptoms of endometriosis, consider joining a support group for women with the condition. It may help you to deal with many of the emotions you are experiencing -- and help you to feel less alone.