Endometriosis is a condition when cells from the inside lining of the uterus are found outside the uterus. It is a very common condition affecting up to 1 in 10 women of reproductive age.
The are a few theories on how endometriosis occurs. The most common theory is retrograde (backwards) menstruation. When a woman has a period, the blood flows out of the vagina, but also backwards along the fallopian tubes into the pelvis. In some women, this endometrial tissue starts to grow outside the uterus.
A major risk factor for endometriosis is family history. Women who have a close relative with endometriosis are up to 7-10 times more likely to get the condition.
Other risk factors of endometriosis are:
– Having first pregnancy at an older age
– Heavy bleeding during periods and longer lasting periods (more than five days)
– Having shorter regular menstrual cycles
SIGNS & SYMPTOMS
The symptoms vary from woman to woman. Some women have many symptoms and severe pain, whereas others have no symptoms
A majority of women with endometriosis have painful periods and pelvic pain.
Some women with endometriosis discover they have it because they have not been able to become pregnant, or because endometriosis is found incidentally during an operation for another reason.
Endometriosis is diagnosed through a laparoscopy.
In the majority of women with endometriosis, the endometriosis found in the pelvis has only implanted superficially on the internal lining of the pelvis and abdomen (called peritoneum) or surface of pelvic organs such as uterus or ovaries. Superficial lesions of endometriosis can never be diagnosed on imaging tests such as ultrasound or MRI as they have no real mass. Ultrasound or MRI can however detect severe endometriosis and endometriosis cysts.
TREATMENTS OPTIONS FOR ENDOMETRIOSIS
Endometriosis is a chronic disease, however there are many treatments available to manage it. Treatments include medical and surgical options; but it is always best to talk to your gynaecologist for treatment options.
Medications include non-hormonal medications to treat pain – such as anti-inflammatory analgesia, and hormonal medications to control or stop menstrual periods – such as the contraceptive pills or progesterone (oral progesterone or progesterone containing intrauterine device).
Hormonal medications also aim to suppress the growth of endometriosis.
Surgery usually involves a laparoscopy to excise the endometriosis.
A hysterectomy is occasionally recommended to treat endometriosis.