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Endometriosis is a painful disorder in which a thick lining of tissues, similar to those formed inside the uterus, develops outside the uterus. The tissue lining formed inside the uterus is known as the endometrium, which grows during the menstrual cycle.
During endometriosis, the endometrial-like tissue is formed around the ovaries, tissue lining of the pelvis, or fallopian tubes. In rare cases, this tissue develops in the areas away from the pelvic organs. This endometrial-like tissue acts like an endometrium, i.e., it grows thick, breaks down, and bleeds during the menstrual cycle.
However, since this endometrial-like issue doesn’t grow inside the uterus, it doesn’t get a way out of the body and gets trapped, forming accumulations. These accumulations can cause irritation and scar tissue formation. This eventually leads to adhesions – fibrous tissue formations that cause pelvic organs and tissues to stick together.
Table of Contents
Signs and Symptoms of Endometriosis
The symptoms of endometriosis may vary in terms of severity. Many women experience a mild impact, while others may get badly affected. Here is a list of the main symptoms of endometriosis.
- Pain in the lower abdomen or back, which may get severe during the period
- Significant period pain that might interfere with the ability to perform routine tasks
- Pain during or after sexual intercourse
- Pain when urinating or emptying bowels during the period
- Blood in your urine during the period
- Sickness, constipation, and diarrhea during the period
- Increased risk of infertility
What Are the Causes of Endometriosis?
Experts are not entirely sure about the exact reasons for endometriosis, but some possible explanations exist. Here is a list of some possible reasons for this condition.
- Retrograde menstruation: During this condition, the menstrual blood containing endometrial cells does not leave the body through the vaginal canal. Instead, it flows back to the pelvic cavity through the fallopian tubes. These endometrial cells attach and accumulate on the pelvic organs’ walls. These accumulations grow with every menstrual cycle.
- Peritoneal cell transformation: According to experts, peritoneal cells – cells present in the inner lining of the abdomen – may transform into endometrial-like cells due to hormonal fluctuations or immune factors.
- Transformation of embryonic cells: Embryonic cells might transform into endometrial-like tissues due to abnormal estrogenic activity.
- Cell implantation into surgical scar: Endometrial cells may get implanted into the surgical incision after a hysterectomy or C-section.
- Problem with the immune system: The body may lose its ability to identify and destroy endometrial-like tissues developed outside the uterus.
Some risk factors of endometriosis include:
- Starting the menstrual period at a young age
- Starting the menstrual period at an old age
- Not giving birth
- Short menstrual cycles
- Heavy menstrual cycles
- Higher estrogen levels in the body
- Family history of endometriosis
- Reproductive tract disorders
How is Endometriosis Diagnosed?
Before proceeding with any diagnostic measure, your doctor will ask you to explain your symptoms. After that, they may choose from the following procedures to diagnose the problem.
Pelvic exam
This check involves palpation of the pelvic areas for abnormalities. In the case of endometriosis, a pelvic exam is a practical option only when the tissue formation is significant enough to cause cysts.
Ultrasound
An ultrasound test involves using high-frequency sound waves to examine internal body organs. For pelvic ultrasonography, your doctor may press a device called a transducer against the skin of the lower abdomen or insert this device into the vagina. Both these techniques generate a clear image of the reproductive organs that help identify endometrial cysts.
Magnetic Resonance Imaging (MRI)
An MRI test uses radio and magnetic waves to develop images of the inside of your body. These images provide essential details of tissue formations, including endometrial implants.
Laparoscopy
Your doctor may refer you to a surgeon for an advanced diagnostic procedure called laparoscopy. This procedure involves a small incision near the navel and is usually performed under general anesthesia.
A small laparoscope tool is inserted into the abdominal cavity through the incision during this procedure. On the tip of this tool is a miniature camera that relays a live video feed to a screen, allowing the surgeon to identify areas with endometrial-like tissue formations.
Laparoscopy allows the surgeon to extract a sample tissue (biopsy) for further testing. In some cases, they may fully treat endometriosis during laparoscopy, eliminating the need for other treatments.
Endometriosis Treatment
Options for endometriosis treatment include medication and surgery. Your doctor will choose a treatment option for you depending on your symptoms and whether you want to or can become pregnant.
Generally, doctors use conservative treatment methods before choosing the surgical option.
Pain Medication
Your doctor may suggest pain relief medications if your only concern is the painful menstrual period. Typically, they recommend NSAIDs like naproxen sodium and ibuprofen. Pain medication can be a standalone treatment or may be combined with other therapies.
Hormone Therapy
Your doctor may recommend hormone therapy if your endometriosis or pelvic pain is due to hormonal fluctuations. These fluctuations cause endometrial implants to thicken, decompose, and bleed. Hormonal treatment may reduce the speedy growth of endometrial cells and prevent new implant formation.
Hormonal therapies to treat endometriosis include:
- Gonadotropin-releasing hormone agonists and antagonists
- Aromatase inhibitors
- Hormonal contraceptives
- Progestin therapy
Conservative Surgery
Conservative surgery is an option to remove endometriosis implants while preserving ovaries and the uterus. This option is for women who want surgical removal of endometrial tissues without losing their ability to become pregnant.
Surgery to remove endometrial tissues is generally performed through laparoscopy. Traditional abdominal surgery is also performed but very rarely.
Endometriosis FAQs
How do I know if I have endometriosis?
Our bodies show symptoms that help diagnose Endometriosis. Patients mostly experience painful periods, pelvic pain, and cramping during menstruation. They may also experience excessive bleeding, lower back, and abdominal pain. Painful bowel movements and intercourse are some other symptoms.
What happens when you have endometriosis?
The patients who have Endometriosis have to go through extreme pain during menstruation. The pelvic pain and cramping also start several days before the period. Moreover, they have pain during intercourse and in some cases, Endometriosis can even lead to infertility.
What will happen if endometriosis is left untreated?
If Endometriosis is left untreated, it causes excessive pain and discomfort during menstruation, intercourse, and bowel movements. Moreover, it can also cause infertility or subfertility in some women making it harder or impossible for them to conceive.
Can you have a baby with endometriosis?
Endometriosis can affect a woman's ability to conceive. It can also cause infertility and subfertility in women. However, having a baby is a possibility for women with Endometriosis. It may be difficult and complicated but it is not always impossible.
Does endometriosis make you infertile?
The fertility of women with Endometriosis gets affected in different ways. It can affect the anatomy of the pelvis, scar fallopian tubes, cause inflammation in the pelvic structures, change the hormonal environment of the eggs, and alter egg quality. In some cases, infertility is a possibility.
Book an Appointment
Endometriosis is a painful disease that can lead to infertility and many other healthcare issues. Fortunately, several medical options are available to treat this problem. You can contact Euromed Clinic Dubai to meet highly skilled gynecologists with top-level expertise in treating issues like endometriosis and other reproductive health problems. Want to schedule a consultation? Please fill out the form below.
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Dr. Sana Azeem
Physician Specialist Obstetrics and GynecologyDr. Sana Azeem is a specialist gynecologist and obstetrician licensed by DHA. She is skillful in performing different surgeries, OPD treatments, as well as aesthetic gynecology procedures.
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