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Endometriosis

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Endometriosis

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Endometriosis is a condition in which tissue that resembles the uterine lining develops outside of the uterine cavity. Read the article to learn more.

Medically reviewed by

Dr. Deepti Kurmi

Published At June 20, 2019
Reviewed AtJuly 12, 2023

What Is Endometriosis?

Endometriosis is a condition in which tissue that resembles the uterine lining grows on other regions of the body. One may encounter uncomfortable symptoms as a result of this tissue's unnatural growth, which may have an effect on regular activities. Some endometriosis sufferers experience difficulties getting pregnant. The uterus's interior lining is called the endometrium. Women lose this tissue when they are menstruating. Endometrium can be visualized as layers of tissue that accumulate along the uterine lining. These layers separate from the uterine walls during menstruation and leave the body. The endometrium supports the early stages of development when women become pregnant.

Endometrial-like tissue develops on various organs or tissues when someone has endometriosis. This tissue may develop in the chest, pelvis, or abdomen. Due to its hormonal sensitivity, this tissue can swell up throughout the menstrual cycle.

Women can get endometriosis in several places, including the following:

  • Behind and outside of the uterus.

  • Fallopian tubes.

  • Ovaries.

  • Vagina.

  • The peritoneum (the lining of the abdomen and pelvis).

  • Ureters and the bladder.

  • Intestines.

  • Rectum.

  • Diaphragm (a vital breathing muscle located close to the bottom of the chest).

Unlike healthy endometrial tissue inside the uterus, which sheds during the menstrual cycle, endometrial tissue developing in these locations does not. Inflammation, scarring, and uncomfortable cysts can result from the accumulation of aberrant tissue outside the uterus. Additionally, it may result in the accumulation of fibrous tissues between the reproductive organs, which makes them "stick" together.

What Causes Endometriosis?

Endometriosis' actual etiology is unknown, but there are a few suggestions as to why it might occur:

  • Transport Through Blood and Lymphatic System: Similar to how cancer cells can spread throughout the body, endometrial tissues are carried to other parts of the body through the blood or lymphatic systems.

  • Direct Transplantation: Following surgery, such as a C-section or hysterectomy, endometrial cells may adhere to the abdominal walls or other body parts.

  • Genetics: Endometriosis runs in some families more than others, suggesting that the ailment may have a hereditary component.

  • Reverse Menstruation: Itoccurs when endometrial tissue enters the fallopian tubes and the abdomen rather than departing the body during a woman's period.

  • Transformation: Cells from different body parts can change into endometrial cells and begin to proliferate outside the endometrium.

What Are the Common Signs and Symptoms?

The most common symptom which a patient may observe is severe pelvic pain which may be commonly associated with periods. This pain may increase with time.

Other signs and symptoms included are:

  • Painful periods or dysmenorrhea.

  • Pain during or after sex.

  • Pain while urinating or bowel movements.

  • Heavy menstrual bleeding or bleeding between periods.

  • It is commonly associated with fertility also. Hence, it is diagnosed in most patients who complain of infertility.

  • Fatigue.

  • Constipation or diarrhea.

  • Nausea.

Endometriosis affects people differently in different ways. Some, all, or none of these symptoms may be present in women with endometriosis. It is not always an indicator of more advanced endometriosis to experience excruciating pain or other symptoms.

endometriosis- signs and symptoms

What Are the Stages of Endometriosis?

Endometriosis can be measured using a variety of methods. The American Society of Reproductive Medicine's scale is the most popular. Points are assigned by doctors based on the extent, depth, and parts of your body that are affected by the endometrial tissue.

The disorder is categorized into one of four stages according to the findings:

Stage 1 or Minimal: A few tiny implants, sores, or lesions are present. They could be on the tissue lining your pelvis or abdomen, or they could be on your organs. Scar tissue is scarce to nonexistent.

Stage 2 or Mild: More implants are present than in stage 1. Additionally, there may be some scar tissue because they are deeper in the tissue.

Stage 3 or Moderate: There are numerous deep implants. On one or both ovaries, individuals might also have little cysts and adhesions, which are thick bands of scar tissue.

Stage 4 or Severe: The most common. They have numerous thick adhesions and deep implants. On either one or both ovaries, there are also sizable cysts.

What Are the Risk Factors and Complications of Endometriosis?

Several things can make women more likely to get endometriosis. These elements may consist of:

  • Endometriosis runs in the family.

  • The age at which the period first begins. Menstruating before the age of 11 may put a person at greater risk.

  • The duration of the flow (how many days of bleeding) and the length of the period one has (how long it lasts).

  • Defects in the fallopian tubes or uterus.

  • The most common complication seen with endometriosis is infertility. The next is ovarian cancer.

One of the most prevalent diseases associated with female infertility is endometriosis. According to research by the American Society for Reproductive Medicine, between 24 and 50 percent of infertile women have endometriosis. Endometriosis in mild to moderate forms may only result in transient infertility. The endometrial tissue can be surgically removed to aid in a woman's ability to conceive.

The precise impact of endometriosis on fertility is unknown to doctors. Endometriosis-related scar tissue can prevent an egg from passing through the fallopian tube and into the uterus or interfere with the release of eggs from the ovaries. Sperm or fertilized eggs may potentially be harmed by endometriosis before they attach to the uterus.

Many women who have endometriosis or infertility caused by endometriosis can nonetheless conceive and carry a healthy pregnancy. In vitro fertilization (IVF) and fertility preservation are two therapy options that may help women get pregnant.

How Is Endometriosis Diagnosed?

The medical history and physical examination may lead the physician to suspect endometriosis, and the following tests may be used to confirm the diagnosis:

  • Laparoscopy: During a laparoscopy, a small incision is made in the abdomen, and a thin tube containing a light and a camera is inserted. This enables the medical professional to examine the tissues within and outside the uterus and look for indications of endometrial tissue growth.

  • Biopsy: The doctor might use a little tool to scrape off a few cells and send them to the lab if questionable tissue is discovered. The tissues are examined under a microscope by a pathologist. Endometriosis must be definitively diagnosed through biopsy.

What Are the Treatment Options for Endometriosis?

Hormone therapy and pain management are the two most popular non-surgical endometriosis therapies. Similar to endometrial tissues inside the uterus, endometriosis tissues are impacted by hormones. Menstrual cycle hormone variations can exacerbate the pain of endometriosis.

Hormone therapy treatments have the power to change the body's hormone production or levels. Hormone therapy may not be appropriate for everyone because it can alter the ability to become pregnant.

Hormone therapy can be administered orally, intravenously, or nasally. The most typical choices are:

  • Hormone-regulating oral contraceptives that contain estrogen and progesterone.

  • Progestins to reduce endometrial tissue growth and menstruation.

  • Limiting ovarian hormones with a gonadotropin-releasing hormone antagonist.

  • To inhibit ovarian hormones, use a gonadotropin-releasing hormone agonist.

  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as Ibuprofen, can be used to treat discomfort associated with endometriosis.

Endometriosis may be treated surgically using:

  • Laparoscopy: During this surgery, a doctor will create a very small incision (less than one centimeter) in your belly and insert a laparoscope, a thin, tube-like instrument, into your body. This device has a high-definition camera that can be used to see inside your body and detect endometriosis. Lesion removal can then be done using additional 5-millimeter tools.

  • Hysterectomy: The surgical removal of the uterus is known as a hysterectomy. This can be a recommendation from a doctor for endometriosis treatment. The removal of the ovaries (oophorectomy), with or without a hysterectomy, may also be advised by a physician. This will limit the release of hormones and should cure endometriosis, yet it will cause menopause.

How to Prevent Endometriosis?

Endometriosis is an idiopathic disorder, which means that its cause is unknown. Additionally, endometriosis cannot be prevented in any particular way. However, being aware of the signs and if one is at increased risk might help determine when to consult a doctor.

Conclusion:

Heavy periods, long-lasting (chronic) pain, and trouble getting pregnant are all possible effects of endometriosis. Working with a medical practitioner, one can control these symptoms. Speak with a physician if one experiences endometriosis symptoms or if the periods seem strange or unpleasant. Some therapies can help one live a better life and manage long-term endometriosis.

Frequently Asked Questions

1.

How Serious Is Endometriosis?

Endometriosis is a condition where tissue growth is seen outside the womb, which is similar to uterus lining causing,
- Pelvic pain.
- Difficulty getting pregnant.
- Abdominal pain.
- Infertility.
- Ovarian cysts.

2.

What Are the Early Symptoms of Endometriosis?

The early symptoms of endometriosis are,
- Severe abdominal cramps.
- Heavy menstrual flow.
- Urinary disorders.
- Painful bowel movements.
- Pelvic pain.
- Urination during menstruation.
- Chronic fatigue.
- Painful sexual intercourse.
- Infertility.
- Bowel disorders
- Nausea or vomiting.
- Long periods.

3.

Does Endometriosis Hurt Every Day?

Endometriosis causes intense pain affecting the daily routine. Patients usually feel sporadic pain with contractions or tightening every few minutes. Sometimes, it will make us feel like we are taking our breaths away with sudden, sharp pains.

4.

How to Check for Endometriosis?

The tests to check for endometriosis are,
Pelvic examination - Palpation in the areas of the pelvis to detect cysts in the reproductive organs.
- Ultrasound.
- Magnetic resonance imaging (MRI).
- Laparoscopy.

5.

Can Endometriosis Be Left Untreated?

If left untreated, endometriosis can lead to a wide range of symptoms like,
- Dysmenorrhoea - Pain during menstruation.
- Pelvic pain.
- Inability to become pregnant.
- Dyspareunia - Pain during sexual intercourse.
- Abnormal uterine bleeding.

6.

Can Endometriosis Go Away on Its Own?

Endometriosis goes away on its own at the stage of menopause (when the periods stop). But up to menopause, the medicines and surgery prescribed by the doctor will help women with the symptoms of endometriosis.

7.

Can You Have a Baby With Endometriosis?

The chances of getting pregnant in women with endometriosis are very low. It is estimated that 70% of women with mild to moderate endometriosis can get pregnant without treatment.

8.

How Can I Reverse Endometriosis Naturally?

Endometriosis can be reversed naturally by following the below,
- Eat plenty of fruits and vegetables.
- A gluten-free diet is beneficial.
- Take soya beans.
- Take a handful of whole grains.
- Increased intake of omega-3 fatty acids.
- Avoid alcohol.
- Follow the low-FODMAP diet.
- Do not have red meat.
- Avoid processed foods.
- Avoid trans fats.
- Limit caffeine.

9.

What Is the Best Medication for Endometriosis Pain?

The best medications for endometriosis pain are pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). Both prescription NSAIDs and over-the-counter NSAIDs are available. The over-the-counter NSAIDs are,
- Ibuprofen.
- Aspirin.
- Naproxen.

10.

Do You Get a Discharge With Endometriosis?

Discharge with endometriosis is common because irregular bleeding, irregular menstrual spotting, and ovarian cysts are caused by this condition and are often linked with the production of potential pink discharge.

11.

How Can I Get Pregnant Fast With Endometriosis?

Getting naturally pregnant with endometriosis or with fertility treatments depends on,
The severity of the condition.
- Age.
- Overall health.
People with mild or stage 1 and 2 endometriosis can get pregnant with superovulation and intrauterine insemination (SO-IUI). Also, fertility drugs like Clomid (Clomiphene) and Gonadotropin are given by doctors.

12.

Does a Hysterectomy Cure Endometriosis?

Having surgery will not always cure endometriosis, but hysterectomy (removal of all or part of the uterus) relieves and prevents further symptoms of endometriosis
in many people, but it can recur after the surgery, and symptoms can persist, so remove all the excess endometrial tissue, along with the uterus.
Dr. Deepti Kurmi
Dr. Deepti Kurmi

Obstetrics and Gynecology

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