Endometriosis causes women to experience pain and irregular hormonal changes, possibly leading to infertility.
Endometriosis is a condition affecting women which causes pain in the pelvic region and is one of the top three causes of infertility. Endometriosis is quite common, plaguing nearly 8.5 million women in North America. In many cases, women can have symptoms for up to 10 years without a proper diagnosis, often being misdiagnosed with conditions like Pelvic Inflammatory Disease.
What Is Endometriosis?
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| Endometriosis can seed anywhere in the pelvic area. (Click To Enlarge) |
During a woman’s monthly period cycle, the body normally sheds blood and cells retained in the uterus. In women with endometriosis, some of these cells abnormally attach themselves to other parts of the pelvic area and implant.
This is sometimes believed to be caused by retrograde menstruation, the term for menstrual flow moving backwards through the fallopian tubes.
Another possible way of contracting the disorder is through Coelomic Metaplasia, in which a woman’s organ linings have the unique ability to transform into other tissues, like a liver cell taking on the characteristics, and eventually becoming, an endometrial cell.
When endometrial cells implant outside the uterus, they continue to grow every month during the woman’s cycle. Often times, these cells cause cysts to grow all over the pelvic region.
In rarer cases, the cells can implant in other parts of the body, from anywhere along the abdominal cavity up toward the head. This usually occurs following surgery or if the cells manage to make their way into the bloodstream or the lymphatic system. Although these implants can cause a host of problems, they are typically benign.
A woman with endometriosis may also have an immune system that acts differently than that of a healthy woman.
Symptoms of Endometriosis
Many women with endometriosis do not experience many symptoms, if any. However, the condition can be incredibly painful and devastating for others.
Many factors play into the severity of the condition; for example, where the implants are located, how much they have grown, and if cysts have developed. In some cases, women have an increased risk of developing ovarian cancer, although endometriosis itself does not directly cause any type of cancer.
Some symptoms women experience with endometriosis are:
- Pelvic Pain, usually during and before the menstrual cycle, sometimes chronic
- Lower back pain during the menstrual cycle
- Irregular or heavy menstrual bleeding
- Pain or cramping during sexual intercourse
- Cramping during bowel movements or urination
- Diarrhea or constipation
- Changes in hormonal balance
- Scarring to affected areas
- Blood in the urine
- Infertility
- Large cysts growing in the pelvic region, that may rupture causing intense pain
- Other symptoms like coughing blood or seizures when implantation occurs in the brain or lungs (very rare)
Diagnosis and Treatment
Many initial tests can be administered to diagnose and to treat endometriosis, beginning with a vaginal exam and an x-ray. Laparoscopy can also be used to visually see the implants, take biopsies, and remove any lesions or cysts.
For women who would like to conceive, many methods exist to relieve symptoms of the condition and to help control the development of implantation. Birth control pills can trick a woman’s body into thinking it’s already pregnant, and by eliminating periods, can control the shedding of endometrial cells, leading to a decrease in the likelihood of these cells from implanting elsewhere in the body.
Treatment with NSAIDS for pain can be helpful. Other hormonal drugs, such as GnRH analogs, progestins, aromatase inhibitors, and male hormones, have also proven to be effective at treating endometriosis. Estrogen supplements can also be administered alongside of these treatments to combat the side effects similar to those from menopause.
In some cases, if medicinal treatments fail to eliminate the growth of implants, surgery may be necessary. Many patients have had success with laparoscopy, but the rate of re-growth is as high as 40%. For women not interested in having children or women for whom all other treatments have failed, a full hysterectomy may be required. However, oral medications may still need to be given post surgery to help relieve any future symptoms.
Most women hoping to conceive will likely still be able to, but treatment is suggested to reduce the risk of miscarriage. Scars in the uterine walls can make the womb unstable and could potentially lead to premature birth. It is less likely that implants will attach or grow during pregnancy, due to the lack of menstruation which can be a causing factor for the growth of cysts and other endometriosis-related growths.
