Endometriosis is an extremely painful chronic disease that is known to affect nearly 6.3 million women and girls across the USA, 1 million in Canada and a whole lot more in other parts of the world. The condition is basically triggered when tissues that line the uterus (also known as the endometrium) are found outside the uterus.
In such a case, the tissues are usually found in the abdomen on the ovaries, fallopian tubes and even the ligaments that support the uterus. It may also be found in the area between the vagina and rectum, the lining of the pelvic cavity and the outer surface of the uterus. Other sites for these endometrial growths may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars. Less commonly they are found in the lung, arm, thigh, and other locations.
With the passage of time, this misplaced tissue forms growths or lesions that respond to the menstrual cycle in the same way that the tissue of the uterine lining does. The tissue builds up every month, breaks down and sheds. For the record, menstrual blood flows from the uterus and exits the body through the vagina. However, the blood and tissue that is shed from endometrial growths does not have any way to leave the body.
This leads to severe internal bleeding, inflammation and breakdown of the blood and tissue from the lesions. It also triggers scar tissue formation, severe pain, adhesions and bowel problems.
6 Symptoms of Endometriosis
Pelvic pain is the primary symptom of endometriosis. It is typically associated with the menstrual period. Although cramping is experienced by most women during their menstrual period, those with endometriosis define the menstrual pain as unbearable. The worst part is that the pain may even increase over time. Also, pelvic pain in such a case may begin a few days before and extend several days into your period. You may also have abdominal and lower back pain.
There are quite a few other symptoms of endometriosis as well. These are inclusive of:
- Pain during intercourse: It’s common for women with endometriosis to have pain during and after sex.
- Excessive bleeding: Women who have endometriosis may experience occasional heavy periods or bleeding between periods.
- Pain in urination and bowel movements: These symptoms are most commonly experienced during periods.
- Infertility: At times endometriosis may also lead to infertility, which is why it may also be diagnosed in women seeking treatment for it.
- Other symptoms: With the onset of endometriosis, affected women may also experience diarrhea, fatigue, bloating or nausea and constipation particularly during their periods.
The one thing that must be mentioned here is that the severity of your pain is in no way an indicator of the extent or stage of the condition. Even women who have mild endometriosis may have severe pain, whereas others who have advanced endometriosis may only experience little to no pain.A few considerations
At times endometriosis may be mistaken for other conditions that are known to trigger pelvic pain. This includes pelvic inflammatory diseases (PID) or ovarian cysts. It may even be confused with irritable bowel syndrome or IBS, which is a condition that leads to severe bouts of diarrhea, constipation and abdominal cramping.
5 Causes of Endomitriosis
Your body sheds the lining of your uterus during a regular menstrual cycle. This process makes it possible for the menstrual blood to flow from your uterus through the small opening in the cervix and out through the vagina. From what is known, endometriosis typically results due to a process known as retrograde menstruation. Because of it, menstrual blood flows back through the fallopian tubes into the pelvic cavity instead of leaving your body.
Once the menstrual blood flows back into the pelvic cavity, the displaced endometrial cells get stuck to the pelvic walls and the surfaces of your pelvic organs including the rectum, bladder and ovaries. With the passage of time, they keep on growing, thickening and continue to bleed over the course of your menstrual cycle. If you have a surgical scar, such as that of a caesarean delivery, there is a good chance that the menstrual blood may even leak into the pelvic cavity.
Other causes of the condition
It’s also believed by doctors that endometriosis may also occur in case the small areas of your abdomen turn into endometrial tissue. This may also happen when the cells in your abdomen grow from embryonic cells that can change shape over time and act like endometrial cells. The reason why this happens is still unknown to experts.
There are four stages or types of endometriosis. These are inclusive of:
There are many different factors that are taken into consideration for the determination of the stage of the disorder. The different factors that are considered for this diagnosis include the:
- Depth of the endometrial implants
When it comes to minimal endometriosis, there are only small lesions together with very shallow endometrial implants on the ovary. Apart from that, there may additionally be inflammation in your pelvic cavity. In a case of mild endometriosis, there may be long lesions and shallow implants on an ovary along with the pelvic lining.
Moderate and severe stages of endometriosis
In terms of moderate endometriosis, the patient typically develops deep implants on both her ovary and the pelvic lining. It’s also typical for a patient of moderate endometriosis to have far more lesions. The last stage of endometriosis is classified as severe. In the most severe stage of this condition, there are deep implants on the pelvic lining as well as the ovaries of the patient. Apart from that, she may even have extensive lesions on the bowels and fallopian tubes.
3 Risk Factors
Nearly 2 to 10 percent of all childbearing women eventually suffer from endometriosis. The condition is typically known to develop years after the start of the menstrual cycle. Although the condition can be extremely painful, it’s necessary for you to understand the risk factors so as to determine whether you are susceptible to the condition and when you should get in touch with your doctor about it.
If truth be told, women of all ages are at risk for endometriosis. However, it particularly affects women who are between 25 and 40 years of age. Also, it’s highly recommended for you to talk to your doctor in case you have a family member who has or had endometriosis. The risk of developing the disease is higher in women who have a family history of the condition.
Apart from that, your pregnancy history would also be taken into consideration in this case as pregnancy is known to protect women against endometriosis. Just so you know, women who do not have children are believed to be at a higher risk of developing the condition. With that, the disorder may also occur in women who have had children, so the risk cannot truly be ruled out.
Menstrual issues can increase your risk of developing endometriosis
It’s extremely important for you to get in touch with your doctor if you have any problems regarding your menstruation. These issues can include heavier and longer periods, shorter cycler or even having menstruation at a young age. All of these issues can place you at a higher risk of developing the disorder.
In order to diagnose endometriosis and certain other conditions that may trigger pelvic pain, you’ll be asked by your doctor to describe your symptoms together with details about the location of your pain and when it occurs. Apart from that, your doctor will also perform a few physical tests in order to acquire a confirmed diagnosis of the condition. These include:
- Pelvic exam: During a pelvic exam, your doctor will manually feel around in your pelvis for signs of abnormalities. These include scars behind your uterus or cysts on your reproductive organs. However, it should be noted here that it is not really possible for small areas of endometriosis to be felt unless they have already caused a cyst to form.
- Ultrasound: During an ultrasound, high-frequency sound waves are used to create images of the inside of the body. In order to capture the images, a transducer is either going to be pressed against your abdominal skin or even be inserted into the vagina if you have a transvaginal ultrasound. Both of these types of ultrasounds may be performed by your doctor so as to acquire a view of your reproductive organs. Although ultrasound imaging is not going to definitely tell your doctor whether you have endometriosis or not, it is meant to identify cysts associated with the onset of endometriosis.
Laparoscopy for diagnosis of endometriosis
Your doctor will initially try to use medical managements for the diagnosis of endometriosis. However, in order to be certain that you suffer from the condition, your doctor may refer you to a surgeon to take a look inside your abdomen for signs of endometriosis by performing a surgical procedure known as laparoscopy.
After putting you under general anesthesia, the surgeon will make a tiny incision near the navel and insert a laparoscope (a viewing instrument) to look for endometrial tissue outside the uterus. Performing a laparoscopy will make it possible for your doctor to acquire information about the extent, size and location of the endometrial implants.
There are quite a few options available these days for the management and treatment of endometriosis. These range from following a healthy lifestyle to hormone therapy with the help of oral contraceptive and progestins together with pain relief medications. A few surgeries that are performed for the treatment of endometriosis are inclusive of laparotomy, laparoscopy and hysterectomy.
Hormone therapy is typically used for the treatment of mild endometriosis or as a combined therapy, either before or after surgery for moderate to severe cases of endometriosis. This therapy is particularly meant to reduce the severity and pain of the endometriosis by stopping any bleeding, including that of the period and suppressing the growth of endometrial cells.
When it comes to surgery for endometriosis, it’s meant to remove as many implants or patches of endometriosis, nodules, cysts, endometriomas and adhesions as possible. Most importantly, surgery is also focused on repairing any damage that may have been caused by the condition.
If your doctor performs a laparoscopy, it will be focused on reducing symptoms and to improve fertility by the removal of cysts, implants, patches and nodules by either burning them or cutting them out.
This is a major surgery that is typically performed in severe or extensive cases of endometriosis. As an open surgery that requires a larger cut in the skin, it may even be performed on patients who have had previous abdominal surgery where laparoscopic surgery is not an option.
7. Getting Pregnant While Suffering From Endometriosis
It’s possible for most women suffering from endometriosis to conceive normally. However, if you’re having trouble in getting pregnant, there’s a good chance that endometriosis is the cause. In such a case, your doctor may choose to perform a laparoscopy in order to make a proper diagnosis.
The diagnosis may further be confirmed with the help of a biopsy. Depending on the severity of the disease, there are quite a few treatment options available these days for women who are diagnosed with endometriosis.
In a majority of cases where surgery is performed for the treatment of endometriosis, the chances of the patient getting pregnant improve significantly. However, you need to bear in mind the fact that pregnancy rates tend to be lower for women with severe endometriosis. Considering that some women with endometriosis have ovulation problems as well, another treatment option includes the utilization of fertility drugs like Clomid so as to induce ovulation.
Your doctor may also choose to use injectable hormones for the same purpose. Once you begin to successfully ovulate, your doctor may suggest trying artificial insemination, in which sperm is inserted directly into your uterus.
A point to consider
You need to bear in mind that certain standard treatments for endometriosis can either prevent pregnancy or cause severe birth defects in cases when the hormone Danocrine is used. For this reason, if you’re being treated for endometriosis, it is highly recommended for you to tell your doctor that you are trying to conceive.