Endometriosis
Endometriosis is a common yet painful ailment that can affect your daily life. When you have endometriosis, the tissue that resembles the uterine lining develops in other locations in your belly and pelvis. In addition to reproductive problems, endometriosis can result in painful, protracted periods.
You may encounter uncomfortable sensations as a result of this tissue's unnatural growth, which may have an effect on your regular activities. Some endometriosis sufferers experience difficulties becoming pregnant.
Your uterus's inner lining is called the endometrium. You lose this tissue when you are menstruating. Imagine layers of tissue accumulating along the uterine interior as endometrium. These layers separate from the uterine walls during your menstruation and exit your body. The endometrium supports the early stages of development if you become pregnant.
Endometrial-looking tissue develops on other organs or tissues when you have endometriosis. Your abdominal, pelvis, or chest may produce this tissue. Due to its hormonal sensitivity, this tissue might swell up throughout your menstrual cycle. Ovarian cysts, deeper nodules, superficial lesions, adhesions, the tissue that joins and binds your organs, and scar tissue inside your body can all be brought on by these patches of endometrial-like tissue.
Endometriosis can develop itself in a number of locations, including,
The outside and rear of your uterus.
Follicle tubes
Ovaries.
Vagina.
Peritoneum (the lining of your pelvis and abdomen)
Ureters and the bladder.
Intestines.
Rectum.
Diaphragma
Types of endometriosis
According to where it is, there are three basic forms of endometriosis:
Superficial peritoneal lesion. The most typical kind is this one. Your peritoneum, a thin layer that lines your pelvic cavity, has lesions.
Endometrioma (ovarian lesion). These black, fluid-filled cysts, commonly referred to as "chocolate cysts," form deep within your ovaries. They can harm good tissue and don't react well to therapy.
Deeply infiltrating endometriosis. This kind of endometriosis develops under your peritoneum and may affect the intestines or bladder or other organs close to your uterus. It affects between 1% and 5% of women with endometriosis.
Symptoms of endometriosis
The main sign of endometriosis is pelvic discomfort, which is frequently related to menstruation. Although many women suffer cramps throughout their periods, individuals who have endometriosis frequently have significantly more severe menstrual pain than usual. Over time, the pain may get worse.
The following are the symptoms of typical endometriosis:
Difficult and painful periods (dysmenorrhea). Before and for a few days after a period, pelvic discomfort and cramps are common. Lower back and stomach aches are also possible.
Pain during intercourse. Endometriosis, many times, causes pain during or after intercourse.
Pain with bowel movements and urination. discomfort when urinating or using the restroom. Heavy bleeding. The menstrual cycle is the time when these signs are most likely to appear. A lot of blood Periodically, you could have thick periods or bleed between periods (intermenstrual bleeding).
Infertility. When a person seeks treatment for infertility, endometriosis is occasionally discovered for the first time.
Additional symptoms and indicators. Especially during menstrual cycles, you can have lethargy, diarrhea, constipation, bloating, or nausea.
The degree of your discomfort may not always be a reliable indicator of how serious your ailment is. Endometriosis can be mild and quite painful, or it might be advanced and barely feel anything.
Endometriosis is commonly confused with other medical disorders, such as pelvic inflammatory disease (PID) or ovarian cysts, that can also cause pelvic pain. It could be mistaken for irritable bowel syndrome (IBS), which also produces stomach cramps, constipation, and episodes of diarrhea. Endometriosis and IBS can coexist, which makes a diagnosis more difficult.
If you have any symptoms or indicators that might point to endometriosis, consult your doctor.
The management of endometriosis may be challenging. Better symptom treatment may be achieved with an early diagnosis, a multidisciplinary medical team, and comprehension of your condition.
Causes of endometriosis
Although the exact reason for endometriosis is unknown, the following things might be a factor:
Retrograde menstruation. During retrograde menstruation, menstrual blood with endometrial cells returns via the fallopian tubes and into the pelvic cavity rather than leaving the body. Throughout each menstrual cycle, these endometrial cells grow, thickening and bleeding on the surfaces of the pelvic organs and pelvic walls.
Cell transformation in the peritoneum. Researchers' "induction theory" holds that hormones or immunological elements induce the peritoneal cells that line the lining of your belly to transform into endometrial-like cells.
Cell transformation in embryos. Early-stage embryonic cells may grow into endometrial-like cell implants when hormones like estrogen are present, during puberty.
Implanting a scar following surgery. After surgery, such as a hysterectomy or C-section, endometrial cells may stick to the incision.
Transport of endometrial cells. Endometrial cells may be transported to different areas of the body through blood vessels or the tissue fluid (lymphatic) system.
Immune system dysfunction. The body may not be able to identify and eliminate endometrial-like tissue that is developing outside the uterus if there is a problem with the immune system.
Is it preventable?
Endometriosis is a disorder that isn't always preventable. Although there are several things you may do to lower your risk, endometriosis may still exist in some people. Some people may develop endometriosis for hereditary reasons. Speak with your doctor about your chance of getting endometriosis if other members of your family (such as your mother or grandmother) have the ailment.
Several elements can lower your chance of developing endometriosis, such as:
Pregnancy.
Breastfeeding.
keeping your weight at a healthy level.
starting your menstrual cycle at a later age.
Risk factors
You run a higher chance of getting endometriosis if, among other things:
You've never given birth.
Getting your first menstruation at a young age.
Having a later onset of menopause.
Shorter than 27-day menstrual periods, for example.
Longer than seven-day heavy menstrual cycles
Longer lifetime exposure to the estrogen your body generates or higher bodily estrogen levels.
Minimal body mass index.
Endometriosis in one or more family members (mother, aunt, or sister).
Any illness that makes it difficult for the body to drain its blood during menstruation.
Issues with the reproductive system.
Typically, endometriosis appears many years after the start of menstruation (menarche). Unless you're taking estrogen, endometriosis signs and symptoms may momentarily become better during pregnancy and may totally go away during menopause.
Complications
Ovarian Cancer
There is evidence that endometriosis patients have higher than average incidences of ovarian cancer. However, ovarian cancer has a low overall lifetime risk, to begin with. Endometriosis may raise this risk, but it is still rather low, according to some research. Even though it's uncommon, endometriosis-associated adenocarcinoma can manifest itself in endometriosis patients later in life.
Infertility
Impaired fertility is the major problem of endometriosis. Between one-third and fifty percent of endometriosis, sufferers struggle to conceive.
An egg must be ejected from an ovary, pass via a nearby fallopian tube, be fertilized by a sperm cell, and then adhere to the uterine wall to start developing in order for pregnancy to occur. The tube may become blocked by endometriosis, preventing the egg and sperm from fusing. However, the illness also appears to have indirect effects on fertility, such as harming sperm or eggs. Nevertheless, many people with mild to moderate endometriosis are nevertheless able to become pregnant and bring it to term. Endometriosis sufferers are occasionally advised by doctors to delay starting a family since the condition might get worse with time.
Diagnosis of endometriosis
A diagnosis of endometriosis frequently begins with your symptoms. You might contact your doctor if you have painful or heavy periods. When you first arrive for your consultation, your doctor (usually an OB-Gyn) may question you about your personal medical history, any prior pregnancies, and whether anybody else in your family has endometriosis.
Pelvic exam and ultrasound. Your doctor could do a pelvic exam. If your healthcare professional wants further details, they'll probably start with an ultrasound before moving on to pelvic imaging.
MRI. An MRI may also be prescribed for further endometriosis mapping, depending on your symptoms, the findings of the physical examination, and the ultrasound results.
Laparoscopy. Both a laparoscopy for a conclusive diagnosis and therapeutic options are possible. Because your doctor doing the process can use a small camera (laparoscope) to examine your body, it can be a great technique to confirm endometriosis.
Biopsy. During this technique, a biopsy (a tiny tissue sample) may be collected. A lab will receive the biopsy to verify the diagnosis.
Endometriosis can occasionally be discovered by chance. Not every endometriosis patient will suffer symptoms. In certain circumstances, your doctor may find the disease while doing a separate operation.
Treatment of endometriosis
Your healthcare practitioner will work with you to develop an endometriosis treatment plan depending on a few variables, such as:
How bad your endometriosis is.
Future pregnancies you have planned.
Age.
How severe your symptoms are (often pain).
In many circumstances, controlling your discomfort and addressing reproductive difficulties will be the main priorities of your treatment strategy, if you are planning on a future pregnancy. Both medicine and surgery are options for achieving this.
The symptoms of endometriosis are frequently managed with the aid of medications. These could include hormone treatments and painkillers.
Endometriosis treatment methods using hormones include:
Birth control
There are multiple forms of hormonal suppression options including combination options using estrogen and progesterone or progesterone-only options. These come in multiple forms including oral birth control pills, patches, vaginal rings, birth control shots, Nexplanon implants, or IUDs. This hormonal treatment often helps people have lighter, less painful periods. These are not options for patients attempting pregnancy.
Gonadotropin-releasing hormone (GnRH) medications
This medication is actually used to stop the hormones that cause your menstrual cycle. This basically puts your reproductive system on hold as a way to relieve your pain. GnRH medications can be taken as an oral pill (by mouth), a shot, or a nasal spray.
Danazol
Another hormonal medicine that prevents the generation of the hormones that induce periods is danazol (Danocrine). You may occasionally have menstrual periods while using this medicine to treat endometriosis symptoms, or they may cease altogether.
It's crucial to keep in mind that with all of these drugs, your symptoms can return if you stop taking them. These drugs shouldn't be taken while trying to get pregnant or while you are already pregnant. Before beginning treatment, discuss the benefits and drawbacks of each medicine with your doctor.
Non-steroidal anti-inflammatory medicines and over-the-counter pain relievers are two possible treatments for endometriosis discomfort (NSAIDs).
Your doctor may occasionally advise surgery to diagnose and manage endometriosis. An operation always carries some risk. However, endometriosis surgery can be a useful method for reducing discomfort and, in some situations, enhancing fertility.
Endometriosis is viewed as a chronic condition. After surgery, many patients report pain alleviation from endometriosis, although the symptoms may come back after a few years. How fast, if at all, your endometriosis returns after surgery may depend on how severe it was initially. For the greatest results, your doctor can advise combining a surgical treatment with medicines. Your doctor could advise pelvic floor physical therapy along with medications for nerve pain. Surgical options such as laparoscopy and hysterectomy are available to treat endometriosis. In vitro fertilization (IVF) may aid you in achieving pregnancy if you have endometriosis and are trying.
You may endure heavy periods, long-lasting (chronic) discomfort, and trouble becoming pregnant as a result of endometriosis. Working with your healthcare practitioner, you can control these symptoms. Speak with your doctor if you have any endometriosis symptoms or if your periods seem strange or unpleasant. There are therapies that can help you live a better life and long-term manage your endometriosis.