Endometriosis is a tissue disorder that causes tissue that would normally be inside the uterus to attach to other parts of the body outside of the uterus. Endometriosis is a very painful condition that can involve the ovaries, the fallopian tubes, the inner lining of the pelvis and the abdominal cavity. This condition typically progresses and worsens over time without intervention. People with endometriosis can suffer from a wide variety of symptoms related to this condition, including adhesions, organ entrapment, and pelvic floor disorders.
The symptoms related to endometriosis can vary in severity for patients, but they do tend to grow worse over time without treatment. Someone might show mild symptoms for a few years and then gradually experience all of the symptoms on this list in increasing severity. The most common symptoms of endometriosis are:
The exact cause of endometriosis is not known at this time. However, there has been research that has linked the condition with the following:
This condition happens when menstrual blood that contains endometrial cells flows back through the fallopian tubes and is released into the pelvic cavity. These cells then stick to the pelvic walls or the internal organs and thicken and bleed, just like the lining of the uterus during menstrual cycles.
This condition is caused when hormones or the immune system cause the peritoneal cells that line the inside of the abdomen to translate into cells that are much more like endometrial tissue. These cells then behave just like the lining of the uterus during monthly menstruation.
Hormones like oestrogen can cause implants of endometrial-like tissue outside the uterus during foetal development in this condition.
It is not uncommon for women who have had surgery like a hysterectomy or a C-section to experience the symptoms of endometriosis when endometrial cells attach to the surgical incision location.
The blood vessels or the lymph system can also transport endometrial cells to other parts of the body.
These kinds of conditions can impact the way that the body recognizes its own cells, leading to the implantation of endometriosis outside of the uterus that is not recognized by the body.
No matter what the reason is for the appearance of uterine tissue in other parts of the body, this tissue acts like the lining of the uterus and bleeds and sheds in the same way. This leads to blood and tissue free-floating in the pelvis and abdomen, which can cause pain and tissue damage. This tissue damage can lead to adhesions, destruction of the fallopian tubes and ovaries, and infertility. Endometrial tissue can also attach to the bowel and the intestines, causing long-term digestive and nutrition issues for patients.
The risk factors for endometriosis are:
Diagnosis without exploratory surgery can be difficult for women with this condition. Most of the damage caused by this condition is internal, which means that it can be hard to visualise without surgery. However, gynaecologists will do a pelvic exam and look for abnormalities in the uterus and ovaries through external palpation. They can also do an ultrasound to look for changes to the shape of the organs and other signs of endometriosis, like cysts.
MRI might also be used to create detailed images of the organs and look for inflammation and lesions. In some cases, diagnosis is made by doing a simple laparoscopic surgery to look at the pelvic cavity and the reproductive organs to see if endometriosis is present.
Many women are not given enough support when seeking a diagnosis for this condition, and it is important that women advocate for themselves as they seek a diagnosis. Many regular gynaecologists are not equipped to diagnose this condition, and it is possible that seeking the support of a specialist is the best route to take when seeking a diagnosis of this condition.
You cannot usually prevent this condition. It is not known why some women seem to be so prone to developing this condition while others are not.
Treatment of this condition typically involves surgery or requires a medication protocol that halts menstruation or eases menstruation. Surgery can involve the removal of the endometrial lesions while sparing the reproductive organs. However, in cases where the endometriosis is severe, a partial or complete hysterectomy might be necessary to halt the progression of the disorder.
Hormone therapy is successful in some cases, and taking contraceptives that block or ease the menstruation process can slow the damage caused by this disorder. Some patients benefit from contraceptive implants like Mirena in place of oral medication. In cases where fertility is in question, supportive care from a gynaecological specialist will likely be required.