Endometriosis: Overview, Symptoms , Causes , Treatment

Overview

Uterine endometriosis is an often painful disorder as a result of tissue growth similar to - endometrium - outside the womb. The most common endometriosis includes the ovaries. Fallopian tubes and pelvic lining tissue. Endometriosis rarely grows outside the pelvic organs.

More informations  

With endometriosis, tissue like endometrium works like normal tissue — characterized by thickening, decomposing, and bleeding with each menstrual cycle. But because these tissues cannot get out of your body, they are locked into the body. When endometriosis affects the ovaries, cysts known as endometriosis may form. The surrounding tissues can become irritated, eventually leading to the appearance of scar tissue and adhesions - abnormal ligaments of fibrous tissue that can cause blockages in the pelvic and organ tissues.

Symptoms

The primary symptoms of endometriosis are pelvic pain, often associated with menstrual periods. Although many women experience cramping during menstrual periods, those with endometriosis describe menstrual pain as much worse than usual. Pain may also increase over time. (1)

Common signs and symptoms of endometriosis include:

 1- Painful menstrual periods (dysmenorrhea). Pelvic pain and cramping may begin before the menstrual period and extend for several days after its onset. You may also feel lower back and stomach pain.

       2- Pain accompanied by sexual intercourse. Pain during or after sex is common with endometriosis.

       

       3- Pain during defecation or urination. You are more likely to experience these symptoms during your menstrual period.

        4- Excessive bleeding. You may experience heavy menstrual periods from time to time or inter-menstrual bleeding (menstrual bleeding).

       5- Sterility. Sometimes endometriosis is diagnosed for the first time in people looking for a treatmen for infertility.

       * Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating or nausea . especially during menstrual periods.

       * The severity of your pain is not necessarily a reliable indication of how severe the condition is. 

       * You may feel severe pain when you develop a simple uterine endometriosis, or you may feel slight or no pain when you develop an advanced endometriosis.

Endometriosis is sometimes confused with other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cyst. It can be confused with Irritable Bowel Syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. Irritable bowel syndrome (IBS) can be accompanied by endometriosis, which makes the diagnosis complicated.

When to visit the doctor?

Visit your doctor if you have signs and symptoms that indicate endometriosis.

Endometriosis can be a difficult when coming to treatment. Early diagnosis, an interdisciplinary medical team, and an understanding of your diagnosis may improve symptom control.

Causes

Although the exact cause of endometriosis is not certain, possible explanations include: (2)

      1- Retrograde menstruation. In the case of menstruation, the menstrual blood that contains the cells of the endometrium flows through the fallopian tubes to the pelvic cavity instead of leaving the body. These endometriosis cells attach to the wall of the pelvic cavity and the surfaces of the pelvic cavities, where they grow and continue to acquire thickness and bleed throughout each              menstrual cycle.

      2- Peritoneal cells transformation. In what is known as "induction theory," experts suggest that hormones or immune factors promote the conversion of peritoneal cells - cells that line the inner side of the abdomen - into cells that resemble the cells of the endometrium.

       3- Embryonic cell transformation. Hormones such as estrogen may convert embryonic cells - cells in the early stages of development - into endometrial cell implants during puberty.

       4- Implanting surgical scars. After surgery, such as a hysterectomy or a cesarean section, endometrial cells may stick to the surgical incision.

      
5-  Endometrial cells transmission. Blood vessels or tissue fluid (lymph) can transfer the endometrium cells to other parts of the body.

       6- Immune system disorder. A problem with the immune system may cause the body to be unable to recognize and destroy the endometrium tissue that is growing outside the womb.

Treatment

Endometriosis is not completely curable, but it can be treated. Sometimes, getting the right treatment requires trying many treatments. (3)

In each of these treatments, there is a possibility that the symptoms of endometriosis will reappear.

The treatment method is chosen according to the goal to be achieved. In some cases, the goal is to treat and hide pains only, while achieving the pregnancy is the goal in other cases.

In order to stop the aches and bleeding, drug treatment or surgery may be approved. When a woman with endometriosis is involved in pregnancy, it is likely that she will have to undergo surgery to remove implants that grow outside the womb.

Uterine endometriosis treatments include

       Pain reliever  -  Contraceptive pills - Hormonal therapy (by giving hormones - Laparoscopic surgery   to remove grafts and scarring.

            In rare cases, in women with very severe aches, surgery can be used to remove the uterus and ovaries. 

       When the ovaries are removed, the level of estrogen falls sharply, often leading to the disappearance of the symptoms of endometriosis. But this excision can also lead to symptoms of menopause and an inability to become pregnant later on.

Women who are close to menopause usually resort to drug therapy, not surgical treatment. This is because endometriosis is not a problem after menopause.