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  Endometriosis

Endometriosis is when tissue that normally lines the uterus is found outside of the uterus on other organs and tissues of the body. Usually, the endometrium, the lining of the uterus, is shed each month, when a mature woman is not pregnant. This disease causes the endometrial tissues to break down and bleed – but while attached to organs and surrounding areas of the uterus. The result is inflammation; sever pain, and possibly infertility. Endometriosis has affected the skin, lungs, diaphragm and brain, in addition to organs and tissues near the uterus with in the pelvic cavity.

Endometriosis Cancer
Endometriosis


Approximately 89 million women world wide suffer from endometriosis.

Symptoms:

This disease can afflict women mildly, moderately and severely and gets worse over time without intervention. Sometimes there are no symptoms and the disease is incidentally discovered during unrelated surgery, such as cesarean section or tubal ligation. Most women experience pelvic pain and cramping that is severe with their periods, both before and during. This pain may be worse in the lower back and abdomen. Other symptoms are piercing pain during intercourse, pain during intercourse, bowel movements or urination. Excessive bleeding can occur during periods and in the middle of a mature woman’s cycle. This disease can also be initially diagnosed during infertility treatment.

This disease is also mistaken for other gynecological conditions such as ovarian cysts and pelvic inflammatory disease. Sometimes it is confused with irritable bowel syndrome, which causes severe cramping, diarrhea and constipation. Endometriosis often accompanies and complicates irritable bowel syndrome.

Pain is no indicator of the severity of endometriosis. Some women can have little scarring and severe pain, while others can have numerous scarring sites and little or no pain.

Diagnosis:

Endometriosis is diagnosed by a gynecologist or obstetrician. A complete physical exam along with a history of pain and other symptoms is the first step. A pelvic exam will detect cysts or other abnormalities to the reproductive system. Scarring and endometrial implantation is virtually impossible to detect through a physical exam.

A vaginal ultrasound will scan the pelvis and abdomen, providing clear images of organs, and can indicate endometrial tissue. A laparoscopy can also be used to detect endometriosis. This procedure is performed under general anesthetic. A small incision is made near the navel and a slender camera or laparoscope is inserted. Carbon dioxide gas is pumped into the abdomen to make the reproductive organs easier to view during the procedure. The surgeon will move the small camera around the abdomen to detect endometrial tissue that is outside the uterus. The surgeon will note the size and placement of the endometrial tissue. This information will help determine treatment choices for this disease. A blood test for the cancer antigen 125 can detect a certain protein found in women with endometriosis. This test is only accurate for women with advanced endometriosis and will not provide accurate results for women in the early or beginning stages of this disease.

Treatment:

Treatment for this disease involves medication or surgery. The choide of treatment depends on the patient, the degree of symptoms and the desire to have children. Over the counter pain medication is usually the first step in managing the pain from endometriosis. If the pain becomes to severe, other prescription medications are available as well as other treatment options.

Hormone therapy is effective in easing and eradicating pain from endometriosis. It is the flux of hormones from the menstrual cycle that causes the endometrial tissue to swell, break apart and then bleed. Hormone therapy can control the fluctuation and therefore the pain. Hormones used for therapy include oral contraceptives and hormomes which block the production of ovarian-stimulation hormones. Depo-Provera, or danocrine(danazol) prevents menstruation and stops the growth of endometrial tissue. Aromatase inhibitors are agents that are used to treat breast cancer. This drug blocks the estrogen production mechanisms of the body, which stops endometrial tissue from swelling and growing.

Therapy treatment for endometriosis is defined as conservative therapy and radical therapy. Conservative therapy is used to remove endometrial lesions, especially if the patient is trying to conceive. Patients with serious pain may also find relief through this procedure. Conservative therapy removes lesions, scar tissue and adhesions without affecting reproductive organs. This surgery is performed using laparoscopy. Radical therapy is a hysterectomy in which both ovaries and the uterus are removed. Patients in severe pain who do not wish to conceive often choose radical therapy. Removal of the ovaries will ensure that endometriosis will not occur again with the patient.

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