Endometriosis - the facts

  • Endometriosis is defined as the presence of endometrium (layer of tissue that lines the uterus) outside the uterus.

  • The condition affects around 10% of women, with the average age of first diagnosis at 28 years old.


  • Women with a family history of endometriosis have a 7-10% higher chance of being diagnosed with this disease.


  • Around 30%-40% of women diagnosed with endometriosis will be termed "subfertile".


  • Common sites of endometriosis include the ovaries, Fallopian tubes, lining of the pelvis, outside the uterus, rectum and bladder.


CAUSES

The exact cause of endometriosis is not defined. However, accepted theories include:

  • Retrograde menstruation – Backflow of menstrual blood containing endometrial cells through the Fallopian tube and into the pelvic cavity rather than out of the body

  • Metaplasia – Transformation of cells lining the inner side of the abdomen (by hormones or immune factors) into endometrial-like cells


  • Heredity – Studies have shown genetic predisposition to this disease in siblings


  • Immune system disorder – Problems with the immune system can create an ineffective mechanism for the body to identify and destroy endometrial-like tissues growing outside of the womb


SYMPTOMS

  • Pelvic pain

  • Dysmenorrhea (painful periods)

  • Pain during sexual intercourse

  • Excessive bleeding

  • Lower abdominal pain

  • Back pain

  • Pain when urinating

  • Dyschezia (painful bowel movement)

  • Fatigue, constipation, nausea, diarrhoea


DIAGNOSIS

During diagnosis, your doctor will go through your medical history as well as perform physical examinations. These include:

  • Laparoscopy - This is the primary common diagnostic used for endometriosis as it has a sensitivity of 97% and can provide information about location, extent and size of endometrial implants

  • Pelvic examination

  • Transvaginal ultrasound

  • MRI -Magnetic resonance imaging


TREATMENT

Treatment of endometriosis is dependent on the severity of the signs and symptoms. The treatment ranges from medication to surgery.

Pain medication - non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen are recommended by doctors to help reduce the pain


  • Laparoscopy – This procedure helps remove displaced endometrial cells without damaging vital organs


  • Hormone therapy – This treatment method helps to lowers oestrogen production and this can be done using birth control pills, gonadotrophin-releasing hormone (GnRH) agonists and antagonists, progestin-only contraceptives and danazol (Danocrine)


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Blog written by Caroline Lina Johnson MMedSci


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