Endometriosis is one of the most common causes of pelvic pain and infertility in women. Women who suffer from this condition have a specific type of tissue that grows outside the uterus. Although it doesn’t always cause symptoms it can cause pain and other problems.
These clumps of uterine tissue which are growing outside of the uterus are called implants. Many women have them growing on the ovaries, the fallopian tubes and the outer wall of the uterus as well as the intestines and other organs in the abdomen.
Every month the uterus grows a specific type of tissue called endometrium. This tissue is what nourishes a fertilized egg and for its a pregnancy. If there is no pregnancy be endometrium breaks down and the body sheds it as the menstrual period.
Women who suffer from endometriosis go through the same cycle except that the implants are outside the uterus so the blood cannot flow out of the body. Instead these implants get irritated and painful and sometimes form scar tissue or fluid filled sacs. The scar tissue can make it difficult to get pregnant especially when they cover the fallopian tubes or the ovaries.
Endometriosis affects women in their reproductive years and is estimated to affect over one million women in the United States alone. It is one of the leading reasons for hysterectomy and laparoscopic surgeries. It has been reported in women as young as 11 years old but is rare in postmenopausal women.
It is more commonly found in women who are Caucasian as compared to African American and Asian women. Some studies have suggested that it is common in women who are taller and who have a low body mass index. Women who delay getting pregnant until an older age may also be placing themselves at higher risk of developing endometriosis.
The most common symptom of endometriosis is help the pain which often correlates to the menstrual cycle. For many women the pain is so severe and debilitating that it impacts their lives in significant ways. Approximately 30 to 40% of women who suffer from endometriosis may not be able to have children.
In rare cases endometriosis has been found inside the vagina, inside the bladder on the skin, and even in the lungs, spine and brain.
Pain might be felt before, during or after menstruation, during ovulation, when passing urine, during or after sexual intercourse or in the lower back region. Some women also suffer from diarrhea or constipation, abdominal bloating and fatigue.
The gynecologists will suspect endometriosis based on the symptoms of pull the pain and findings during a physical examination in the office. Occasionally, during a recto vegetal exam the doctor will feel nodules behind the uterus and along the ligaments that attach to the pelvic wall. This examination often causes unusual pain or discomfort.
Unfortunately, the physicians will also require imaging studies such as alter sounds, to rule out other pelvic diseases. For a completely accurate diagnosis a direct visual inspection inside the pelvis and abdomen as well as tissue biopsies are necessary. For this reason the only accurate way of diagnosing endometriosis and ruling out other pelvic diseases is a laparoscopy with biopsy.
While the cause for endometriosis remains unknown there are several treatment protocols which physicians may be able to try in order to decrease the symptoms which women experience. A complete treatment which fully cure is endometriosis has not yet been developed and there is no medical evidence to support one specific type of treatment over another.
For this reason, choosing a treatment protocol comes down to the individual woman’s needs and will depend upon her symptoms, age and her desire to have children. Treatment plans will include pain medications and order to adequately manage the pain and hormonal therapies to attempts to decrease the amount of estrogen production in a woman’s body.
Endometriosis is exacerbated by estrogen and such treatments can subsequently relieve symptoms. Physicians may try using a combined oral contraceptive pill, progesterone, gonadotropin releasing hormone and aromatase inhibitors.
If these conservative methods of treatment are not successful the gynecologists may recommend surgical treatments. Surgery is the preferred treatment when there is an anatomic distortion of the Oregon’s war and obstruction of either the bowel or urinary tract. If the surgeon is able to leave the uterus and ovaries and taxed they can carry out the surgery using laparoscopy and excise or obliterate endometrial implants using laser.
However, if the disease is extensive then an open laparotomy may be required in order to remove either the uterus or the uterus and ovaries.
Whatever the treatment protocols are attempted the gynecologists will discuss the options with the individual and base recommendations on her age, severity of her disease and her desire for children.
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