Introduction:
The menstrual cycle is a crucial part of the female reproductive system. It is crucial to help women prepare for pregnancy and develop secondary sexual characteristics. During the menstrual cycle, there is shedding of cells lining the uterus called the endometrial cells. These endometrial cells or tissues, if found lining outside the uterus or any other location like the ovaries or fallopian tubes, may result in endometriosis. In endometriosis, due to the presence of endometrial cells, the cells and tissues are influenced by hormonal changes. Endometriosis is usually diagnosed as an accidental finding during a routine examination. Individuals may or may not have any symptoms. It presents as a painful condition with constant pelvic or abdominal pain. The pain can be intolerable for most individuals. In severe cases, it may result in endometrial lesions. Early diagnosis of the condition can prevent further complications.
What Is Endometriosis?
Endometriosis is a condition characterized by chronic tissue growth outside the uterus, which normally lines inside it. This tissue can be found in various locations like ovaries, fallopian tubes, and pelvic lining. In some cases, it may spread beyond the pelvic region. During menstruation, the body thickens the endometrial tissue to prepare an individual for pregnancy. If pregnancy does not occur, the tissues gradually break down and shed during the menstrual bleeding. However, in endometriosis, the displaced tissue also reacts to hormonal changes, resulting in pain and scar tissue formation.
The condition affects about 10 percent of women during their reproductive age and causes a wide range of symptoms like pelvic pain and painful periods. It could also interfere with fertility by causing structural changes and scarring in reproductive organs. A few women with endometriosis may have unusual, irregular menstrual bleeding.
What Are the Symptoms of Endometriosis?
The symptoms of endometriosis may vary from one person to another. Usually pelvic pain is commonly found among most individuals during the menstrual cycle. Though it is quite common to experience muscle cramps during the menstrual cycle, the pain associated with endometriosis is severe. Over time, individuals may complain of increased pain. A few common signs and symptoms are mentioned below:
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Dysmenorrhea - A condition characterized by severe pelvic pain and cramping before the duration of the menstrual cycle. Additionally, individuals experience lower back pain and abdominal pain.
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Patients with endometriosis experience pain during or after intercourse.
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Pain during urination and bowel movements.
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Occasional menstrual bleeding.
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Fatigue.
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Nausea.
The condition is usually mistaken for causes like pelvic pain and inflammatory disease.
What Are the Causes of Endometriosis?
The exact cause of endometriosis is not known; however, a few possible reasons a listed below:
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In retrograde menstruation, the blood, along with endometrial cells, flows through the fallopian tubes and reaches the pelvic cavity. These cells stick to the pelvic walls, where they keep growing and continue to thicken the bleeding during each menstrual cycle.
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The cells lining the pelvic cavity have the capability to transform into endometrial-like cells. They may develop into endometrial lesions due to the influence of the hormone, resulting in endometriosis.
How Is Endometriosis Diagnosed?
Usually, endometriosis is diagnosed as an accidental finding when an individual experiences pain during the menstrual cycle. The health professional will take a detailed medical history and personal history. The health professional may perform a pelvic examination by taking pelvic images with an ultrasound. Based on the symptoms, physical examination, and ultrasound results, a definitive diagnosis will be made by the health professional. In addition, a laparoscopy may also be done to look inside the tissues in the body. A biopsy may also be taken during this procedure. It will also be sent to the lab to confirm the diagnosis. Sometimes endometriosis is an incidental finding during a routine check-up, as some individuals may not experience any form of symptoms.
How Are Hormones and Endometriosis Interlinked?
There is a close relationship between hormones and endometriosis. It is a condition in which the lining of the uterus, called the endometrium, grows outside the uterus. Estrogen plays a significant role in the development and progression of endometriosis. The tissue growth is influenced by hormonal changes that occur during the menstrual cycle. Normally, the endometrium thickens and sheds at the end of each month. This occurs in response to hormonal fluctuations. In women with endometriosis, the ectopic tissue growth also responds to hormonal changes, leading to inflammation and pain.
During menstruation, the level of estrogen rises, causing the thickening of the endometrium in preparation for pregnancy. Apart from estrogen, progesterone is another hormone involved in endometrium growth. This hormone prepares the body for the potential implantation of fertilized eggs. During endometriosis, progesterone resistance may develop, which may contribute to the growth and survival of endometrial lesions. Both these hormones create a hormonal imbalance, with estrogen dominating over the other. This imbalance further leads to the persistent growth of endometrial lesions resulting in pelvic pain and irregular periods.
Treatment approaches usually aim to modulate hormone levels to inhibit their effects. Oral contraceptives or birth control pills can help to control the production of estrogen levels. Various other hormones, like progestins and aromatase inhibitors, can be used to suppress estrogen production. It temporarily induces a menopause-like state, which gradually slows down the progression of the disease. Although hormonal factors are strongly associated with endometriosis, it does not clearly explain the development or progression of the condition. Endometriosis requires a multifactorial approach for comprehensive management and treatment.
Conclusion:
Endometriosis is a chronic condition with tissue growth outside the uterus. Various hormonal factors, specifically estrogen and progesterone, play a crucial role in the progression of endometriosis. The misplaced tissue responds to the hormonal imbalance resulting in pain and inflammation. The exact cause is yet to be known, but some of the common reasons include retrograde menstruation and immune system dysfunction. It causes painful periods and pelvic pain. Diagnosis of the condition involves medical and pregnancy history. The treatment may vary depending on the symptoms, causes, and area of the lesion or tissue. Mostly the excess unwanted tissues will be removed safely without harming the surrounding tissues.
