What is endometriosis?
Endometriosis is a condition in which the tissue lining the uterus (endometrium) grows at extrauterine sites. It is seen in the ovaries, uterine tubes, vagina, cervix or intestine. It is an extremely painful condition that affects approximately 6% to 10% of women of reproductive age in the U.S.
What are the causes of endometriosis?
- Family history of endometriosis
- Early onset of menarche (the first menstrual cycle)
- Short menstrual cycle (less than 27 days)
- A long duration of menstrual flow (longer than seven days)
- Immense bleeding during menses
- Delayed childbearing chances
- Defects in the uterus or fallopian tubes
- Iron deficiency or low oxygen concentration leading to an early onset of endometriosis
How do I know if I have endometriosis?
Approximately, one-third of the women with endometriosis remain asymptomatic. Severe pain during menses may be the first sign of endometriosis. Other symptoms that you may experience include
- Heavy or irregular bleeding
- Lower back pain
- Pain while urinating
- Menstrual cramps
- Pain in the pubic area
- Pain during exercise
- Pain during intercourse
- Painful bowel movements with alternating diarrhea or constipation
Other uncommon signs are
The symptoms mainly depend on the area affected; hence, they may vary from individual to individual.
The degree of pain is not associated with the extent of the disease because patients with severe pain may have mild endometriosis and vice versa.
How is endometriosis diagnosed?
The physician performs the following tests to diagnose endometriosis
What are the treatments for endometriosis?
The treatment of endometriosis includes medical and surgical methods. Medical management uses hormonal therapy to suppress hormones.
The most commonly used hormonal therapies as well as oral contraceptives are as follows
- Medroxyprogesterone acetate
- Desogestrel and ethinyl estradiol
- Norgestimate/ethinyl estradiol
Surgical therapy involves destroying endometrial mass and breaking the bond between the fallopian tube and ovary that interferes with the ovum transport. The different techniques used are as follows
- Laparoscopic surgery
- Laser therapy
- Removal of nerve bundles
What to expect after endometriosis treatment
- The medical therapy may continue for six months. Taking the medications regularly as prescribed is important.
- It is important to know that medical therapy may have other adverse effects.
- Endometriosis is a progressive disease. It is one of the causes of infertility and chronic pelvic pain.
- Individuals may develop the symptoms again within five years of medical therapy.
- Minimally invasive surgery results in a better fertility rate.
- The symptoms usually go away after a woman reaches menopause.
- Pregnancy is possible for individuals with endometriosis, although it may require fertility treatment.
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Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and infertility.
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