Endometriosis
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Endometriosis is one of the most common gynecological diseases, affecting more than 5.5 million women in North America
alone. The two most common symptoms of endometriosis are pain and infertility. Some women have pain before and
during their periods, as well as during or after sex. This pain can be so intense that it affects a woman’s quality of life, from
her relationships, to her day-to-day activities. Some women don’t have any symptoms from endometriosis. Others may not
find out they have the disease until they have trouble getting pregnant.
Endometriosis occurs when tissue like that which lines the inside of uterus grows
outside the uterus, usually on the surfaces of organs in the pelvic and abdominal
areas, in places that it is not supposed to grow.
The word endometriosis comes from the word “endometrium”—endo means
“inside” and metrium (pronounced mee-tree-um) means “mother.” Health care
providers call the tissue that lines the inside of the uterus (where a mother carries
her baby) the endometrium.
Health care providers may call areas of endometriosis by different names, such as
implants, lesions, or nodules.
One of the most common symptoms of endometriosis is pain, mostly in the abdomen,
lower back, and pelvic areas. The amount of pain a woman feels is not linked to how
much endometriosis she has. Some women have no pain even though their
endometriosis is extensive, meaning that the affected areas are large, or that there
is scarring. Some women, on the other hand, have severe pain even though they
have only a few small areas of endometriosis.
General symptoms of endometriosis can include (but are not limited to):
* Extremely painful (or disabling) menstrual cramps; pain may get worse over time
* Chronic pelvic pain (includes lower back pain and pelvic pain)
* Pain during or after sex
* Intestinal pain
* Painful bowel movements or painful urination during menstrual periods
* Heavy menstrual periods
* Premenstrual spotting or bleeding between periods
* Infertility
In addition, women who are diagnosed with endometriosis may have gastrointestinal
symptoms that resemble a bowel disorder, as well as fatigue.
Endometriosis can affect any menstruating woman, from the time of her first period to
menopause, regardless of whether or not she has children, her race or ethnicity, or
her socio-economic status. Endometriosis can sometimes persist after menopause;
or hormones taken for menopausal symptoms may cause the symptoms of
endometriosis to continue.
Current estimates place the number of women with endometriosis between 2 percent
and 10 percent of women of reproductive age. About 30 percent to 40 percent of
women with endometriosis are infertile, making it one of the top three causes of
female infertility. Some women don’t find out that they have endometriosis until they
have trouble getting pregnant.
What are the causes for endometriosis?
Endometriosis may result from something called “retrograde menstrual flow,” in which
some of the tissue that a woman sheds during her period flows into her pelvis. While
most women who get their periods have some retrograde menstrual flow, not all of
these women have endometriosis. Researchers are trying to uncover what other
factors might cause the tissue to grow in some women, but not in others.
Another theory about the cause of endometriosis involves genes. This disease could
be inherited, or it could result from genetic errors, making some women more likely
than others to develop the condition. If researchers can find a specific gene or
genes related to endometriosis in some women, genetic testing might allow health
care providers to detect endometriosis much earlier, or even prevent it from
happening at all.
Researchers are exploring other possible causes, as well. Estrogen, a hormone
involved in the female reproductive cycle, appears to promote the growth of
endometriosis.
Why does having endometriosis cause pain?
Normally, if a woman is not pregnant, her endometrial tissue builds up inside her
uterus, breaks down into blood and tissue, and is shed as her menstrual flow or
period. This cycle of growth and shedding happens every month or so.
The endometriosis areas growing outside the uterus also go through a similar cycle;
they grow, break down into blood and tissue, and are shed once a month. But,
because this tissue isn’t where it’s supposed to be, it can’t leave the body the way a
woman’s period normally does. As part of this process, endometriosis areas make
chemicals that may irritate the nearby tissue, as well as some other chemicals that
are known to cause pain.
Over time, in the process of going through this monthly cycle, endometriosis areas
can grow and become nodules or bumps on the surface of pelvic organs, or become
cysts (fluid-filled sacs) in the ovaries. Sometimes the chemicals produced by the
endometriosis can cause the organs in the pelvic area to scar, and even to scar
together, so they appear as one large organ.
Is there a cure for endometriosis?
Currently, we have no cure for endometriosis. Even having a hysterectomy or
removing the ovaries does not guarantee that the endometriosis areas and/or the
symptoms of endometriosis will not come back.
Are there treatments for endometriosis?
There are a number of treatments for both pain and infertility related to
endometriosis- pain medication, hormone therapy and surgical treatment.
SOURCE: http://www.nichd.nih.gov/publications/pubs/endometriosis/sub2.cfm#what