Endometriosis: Causes, Symptoms, Stages and Treatments

What is Endometriosis?

Endometriosis is a condition in which the tissues that line the uterus(womb)-the endometrium- are found outside the uterus in other organs such as the fallopian tube, ovaries and pelvis.

These displaced tissues will continue to grow, shed and bleed each month like they normally do in the uterus. But the tissues will have no way to leave the body as it becomes trapped in the fallopian tube, ovaries and pelvis organs.

Endometriosis causes mild to severe pain and cramping most especially during periods.

Causes of Endometriosis?

Although the main cause of endometriosis is unknown, some combination of factors are believed to lead to it.

Retrograde mensuration

Normally during menstruation blood flows from the uterus through the cervix into the vagina. With retrograde menstruation, there is a backward flow of blood from the uterus through the fallopian tubes into the pelvic cavity.

Although a very little backward flow of blood is common in 90% of women and it is considered normal. Women with larger volumes of blood flowing backwards are at a higher risk of developing endometriosis.

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During reverse menstruation, blood and endometrial tissues flows in the opposite direction to attach and implant themselves in other organs such as the fallopian tubes, ovaries and pelvis.

Retrograde menstruation is one of the most speculated causes of endometriosis.

Genetics

Researches done in Australia, UK and America found out that endometriosis is 51% hereditary.

According to the study, conducted in University of Oxford, England, it was discovered that there is a strong evidence in DNA variation that makes it more likely for some women to develop endometriosis.

It is important to know that endometriosis is a complex condition, genetics is only a part of what causes the disease.

Immune System Disorder

It is discovered that women who have endometriosis, have a an immune system that is not working or functioning properly.

The immune system is unable to recognise and fight off displace endometrial tissues.

Women with endometriosis are at a greater risk of developing auto immune inflammatory diseases such as multiple sclerosis, chronic fatigue syndrome, rheumatoid arthritis.

Lymphatic or Circulatory Spread

The lymphatic system or the circulatory system is also known to transport endometrial particles around the body.

Endometriosis can develop in far places like the eyes and brain when the endometrial tissues are transported ​through the circulatory system.

Symptoms Of Endometriosis

The symptoms of endmetriosis varies from woman to woman. Some women have severe symptoms while others do not notice any symptoms at all.

Common Symptoms include:

  • Pelvic Pain​
  • Painful periods (dysmenorrhea)
  • Heavy Periods
  • Pain during bowel movement and urination
  • Pain during and after intercourse
  • Tiredness and Fatigue​
  • Fertility Problems​

Diagnosis

Your doctor will ask questions about the symptoms you are feeling.

He/She will then carry out a series of test to confirm traces of endometriosis.

The tests carried out are:​

Pelvic Examination

A thorough check of your pelvic organs would be conducted. The Doctor or the Nurse would check the vagina, cervix, uterus, fallopian tubes and ovaries for abnormalities including cysts.

A pelvic examination is usually done to find the cause of pain or infections.

Ultrasound

High frequency sound waves are used to produce images of what is happening inside your body.

Laparoscopy

Laparoscopy is a surgical procedure that allows surgeons to look inside the abdomen.

Stages of Endometriosis

The stages of endometriosis is classified in four different stages. These staging was developed by the American Society of Reproductive Medicine.

During laparoscopy diagnosis, the surgeon makes a small cut or incision in the lower abdomen to observe the fallopian tubes, ovaries, pelvis, intestines, bowels and other pelvic organs.

The stages are determined by the following factors: location, size, amount, depth or the endometrial tissue.

Stage 1 ( Minimal)

Stage 1 is minimal endometriosis. In which there are endometrial implants but no big adhesions.

STAGE 2 (MILD)

Stage 2 is mild endometriosis. In which there are shallow implants on the ovaries and pelvis region.

STAGE 3 (MODERATE)

Stage 3 is moderate endometriosis. It is characterised by deep implants and small adhesions.

STAGE 4 (SEVERE)

Stage 4 is severe endometriosis. It is charactered by multiple deep implants, chocolate cysts on one or both ovaries and deep adhesions on other organs.

Treatment of Endometriosis

Endometriosis is still an incurable disease. But there are some treatments that can reduce the symptoms from the condition.

Anti-inflammatory Pain Relief

Non-steroid anti inflammatory Drugs such as ibuprofen, Voltarol and naxproxen are prescribed to help relieve pelvic pain and menstrual cramping caused by the disease.

They work by blocking the production of prostaglandins in the body.

Prostaglandins are hormonal-like substances that sends messages to the brain during injury.

They control processes such as inflammation, blood flow and the formation of blood clot.

They also cause the uterus to contract during period and during labor.

Women with endometriosis have high levels of prostagladins.

Pain killers and pain reliefs helps to stop the production of prostaglandin, thereby stopping the pain.

Hormone Treatments

Hormone treatments that block the production of estrogen hormone are often recommended for women with endometriosis.

Endometriosis continue to grow as they as exposed to estrogen hormone. Using hormonal contraceptives and therapies are useful in stopping the growth of the endometrial tissues.

Hormonal medicines and contraceptives such combined pill, contraceptive patch, inter uterine device(IUD) are often prescribed.

Also hormonal medicine such as gonadotropin releasing hormone (GnHR) analogues are used to prevent the production of ovarian-stimulating hormones.

Conservative Surgery

If your endometriosis is accompanied by severe pain, a surgery may be used to remove endometriosis.

Surgerys can be conservative(removing growths) or radical (hysterectomy and ovaries removal).

If trying to conceive a conservative surgery is needed to preserve the uterus, fallopian tubes and ovaries.

In very severe cases a surgery is recommended to remove the uterus, cervix and ovaries.

Hysterectomy alone isn't sufficient in the treatment of endo, because ​endometriosis may still return after hysterectomy due to the production of estrogen hormone.

Hysterectomy

Hysterectomy is a surgery undertaken to remove the uterus(womb) after hysterectomy a woman is unable to get pregnant.

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