Endometriosis is a condition in which the normal tissue of the inner pert of the uterus grows outside its normal location. Commonly affected locations are; ovaries, fallopian tubes, tissues around the ovaries and at times distant organs such as the lungs.
Endometriosis is a non cancerous lesion. However, some studies have have shown that those with ovarian endometriosis are more at risk of having epithelial ovarian cancer. A family history of endometriosis alsoincreases your chances of having it.
Endometriosis affects 6-10% of women of reproductive age group worldwide. It is commonly diagnosed in women in their twenties and thirties. It has however been discovered in girls as young as 11 years.
The cause of endometriosis is not clear. Some of the causative theories are;
Auto immune disorder theory; autoimmunity occurs when the immune system of an organism responds against its own healthy cells and tissues. Endometriosis increases the chances of having Graves’ disease and auto immune disease of the thyroid gland. Therefore the theory thinks endometriosis is due to abnormality in the immune system.
Environmental toxins such as nickel and dioxin have been linked to the risk of having endometriosis.
Retrograde menstruation which suggests that some endometrial debris flow backwards through the fallopian tubes into the peritoneal cavity during menstruation.
About 25% of women with endometriosis have no symptom. The symptoms typically manifests during the reproductive years and they include;
- Pelvic pain; this is the most common symptom in women with endometriosis and the severity of the pain depends on the location of the endometrial implant. If the implant is located in areas with high nervous supply the pain will be more. Also, pelvic pain can be due to scaring of affected tissue by the endometrial implant.
- Pain during sexual intercourse
- Infertility; this can occur in up to 50% of affected women. This is due to scar formation in the affected pelvic tissues which can lead to obstruction of the fallopian tubes and prevent the release of eggs into the uterus for fertilization. Also, endometriosis may lead to release of some chemicals that can affect ovulation, fertilization and implantation.
- Painful menstruation which is not relieved by the use of pain medications.
- Irregular or painful menstruation
- Pain during bowel movement or when urinating
- Chronic fatigue
- Low back pain Symptoms that can occur if there is a distant implant (very rarely) of endometrial tissue includes;
- Chest pain or coughing out blood especially during menstruation if the lungs is affected
- Headache and seizures if the brain is affected
Pregnancy can lead to a temporary relief from the symptoms while menopause can lead to a permanent relieve from the symptoms. However, the use of hormone supplements during menopause can lead to persistence of the symptoms.
There is currently no cure for this ailment. It is however a manageable condition. The following treatment options can be used;
Hormonal treatment; birth control pills such as intrauterine contraceptive device with progesterone can be used to improve symptoms. The use of Depo-Provera which stops menstruation can be used to stop the growth of the endometrial implants and thereby reducing the pain. The use of gonadotropin releasing hormone agonist can also help toimprove fertility in infertile women.
Pain medication such as NSAIDS can help reduce the pain.
Surgery; this is the last resort in the management of endometriosis. Laparoscopic surgery which is minimally invasive can be used to diagnose and remove the endometrial implant. The womb (uterus and the cervix) can be removed if the condition doesn’t improve with other treatment options. It’s important to however note that you can’t get pregnant after the womb is removed.
Endometriosis is a chronic condition that has no cure and can’t be prevented. It can be managed and it shouldn’t affect your daily living. Endometriosis can alsovlead to depression and psychological meltdown, it is important you seek help if you notice this.