Endometriosis

The inside of the uterus is covered with a special lining of tissue, called endometrium. This tissue serves as a “bedding” for the fertilized egg that will develop into a foetus and, eventually, a baby. The egg is released once a month through the process known as ovulation.

If the egg is not fertilized, the endometrium is flushed out of the body during the menstrual period and then regenerates until the next ovulation. All these processes are triggered by hormones produced by the ovaries. When hormones are produced in different quantities and concentration than normal, different other problems can derive.

Sometimes the endometrial tissue happens to develop outside the uterus and can be quite painful.

The endometrial tissue can develop in the pelvian area: in the ovaries, the fallopian tubes, right outside the uterus or in the space behind it, in the intestines, rectum or even bladder.

During the menstrual cycle, the tissue acts as it would normally do if it were in the uterus: it sheds and bleeds away. If this happens monthly, it can lead to scar tissue or even to adhesions that bind organs together.

Endometriosis occurs more often among women between 30 and 40 years of age, but any women who menstruates can suffer from it. The risk of geting endometriosis has a genetic component; that is, if a close relative has it, the risk is higher.

Symptoms

The most common symptom of this problem is pain in the pelvic area. Pain during urination, sexual intercourse or around the time of the menstrual cycle is a general indcator. Also, having two periods in one month can indicate endometriosis. Still, these symptoms are not a certain indicator of endometriosis, so a visit to a doctor is highly recommended in order to determine an accurate diagnosis.

Causes

There are no certain causes of endometriosis. Sometimes a little blood and cells from the endometrium can get into the fallopian tubes and even the blood and limphatic system. Also, pain is not an indicator of the gravity of this disease, and there also can be no symptoms at all. Having this disease can significantly increase the infertility risk.

Diagnosis

Endometriosis may be diagnosed after a pelvic exam and it can be fully investigated by performing a laparoscopy.

Laparoscopy is a surgical procedure performed under general anesthesia, used to diagnose and treat endometriosis. It is performed by doing two incisions in the abdominal cavity, through which two thin tools are inserted: the laparoscope and a tube that pumps gas in the cavity to help the doctor get a better view of the reproductive organs. The doctor can also remove the endometrial tissue during the laparoscopy.

Treatment

Each treatment is adjusted to each patient, depending on the gravity of the disease and on the wish to have children in the future. There are some treatments that can relieve the pain, i.e. the symptoms, but the complete treatment can include both medication and surgery. Along with pain relieving medication, hormones can be administered, because they influence the process of endometrial tissue formation. Some of these medications can be in the form of birth control pills, gonadotropin-releasing hormone and progestin. All these treatments can have various adverse effects.

Endometriosis can be treated surgically, not only by laparoscopy but by laparotomy, a type of surgery used to investigate the abdominal cavity and to remove endometrial tissue.

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