Endometriosis is a condition where tissues similar to those lining the uterus grow outside the uterus, thus leading to pain in the pelvis which can affect one’s fertility. It mostly occurs in the fallopian tube, ovaries, and tissues that line the pelvis.
Causes.
- Peritoneal cell transformation where immune factors can contribute to cells lining the abdomen to change to endometrial-like cells.
- Retrograded menstruation- menstrual blood that has endometrial cells does not leave the body rather it flows back through the fallopian tube into the pelvic cavity. The endometrial cells stick to the pelvic wall, grow and continue to thicken and bleed during the menstrual cycle.
- Reproductive hormones such as estrogen may contribute to embryonic cell transforming into endometrial-like cell implants at puberty.
- Endometrial cells may attach to a surgical incision after a surgical procedure such as a C-section.
- The body may at times fail to recognize endometrial tissues and destroy them when there is a disorder with the immune system.
- Endometrial cell transportation through the blood vessels to other body parts.
Symptoms of endometriosis.
- Pain during sexual intercourse.
- Painful menstrual period which may start before even the period and sometimes extend.
- Heavy menstrual bleeding.
- Nausea.
- Pain when passing urine or when having a bowel movement.
- Sometimes it may affect one’s fertility.
Risk factors of Endometriosis
Factors that put one at a greater risk of developing endometriosis are:
- Excessive menstrual period that prolongs to more than a week.
- A female who has not given birth.
- Starting with menopause at a late age.
- Early starting of periods.
- Low mass index.
- Short periods e.g. less than 27 days.
- Family history.
- Reproductive tract disorders.
- Any underlying medical condition that prevents menstrual blood from flowing from the body.
- Having high estrogen levels in the body.
Complications.
- Infertility – most females who suffer from endometriosis find it difficult to get pregnant, as sometimes endometriosis may obstruct the ova and the sperm.
- Cancer – the risk of getting ovarian cancer is high for those with endometriosis.
Diagnosis.
- Pelvic examination – the doctor palpates the pelvic area to check for any abnormalities such as cysts.
- Use of an ultrasound- to show the appearance of the reproductive organs.
- Magnetic resonance imaging – use a magnetic field and radio wave to give detailed images of the organs and tissues within your body thus helping in planning surgery if the need arises.
- Use of a laparoscope as it provides information about the location and the exact size of the endometrial implants.
Treatment.
- Use of pain medication e.g. ibuprofen, naproxen sodium to give relief for those who experience severe pain that is unbearable at times.
- The use of hormone therapy slows down the growth of endometrial tissue and prevents new implants of endometrial tissue. The therapies used are:
- Use of aromatase inhibitors which reduces the amount of estrogen in the body.
- Agonists and antagonists of gonadotrophin-releasing hormone which blocks the production of ovarian-stimulating hormones, lowers estrogen levels, and prevents menstruation thus making the endometrial tissues shrink.
- The use of hormonal contraceptives such as birth pills helps to control hormones responsible for endometrial tissue buildup.
- Progestin therapy like contraceptive injections stops menstrual periods and the growth of endometrial implants thus easing the symptoms of endometriosis.
3. Conservative surgery where endometriosis implants are removed while preserving the uterus and the ovaries.
4. Use of fertility treatment under the supervision of a fertility specialist.
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