Endometriosis

Endometriosis: Symptoms, Causes, Diagnosis, Treatment, and Prevention

What is Endometriosis?

Endometriosis is the gynecological condition resulting from the development of endometrial tissue outside uterus at some other place in the body, most commonly in fallopian tube, ovaries or in pelvic structures. The disorder may lead to pain and infertility.

The word endometriosis has its origin from the Greek language. Endo means ‘inside’ and metra means ‘womb’.

Endometriosis is the abnormal condition characterize by the development of endometrial tissue at sites other than uterus, like in fallopian tubes, ovaries and other pelvic structures.

Such condition may result in excruciating pain at the time of your menses.

Common sites of abnormal endometrium development:

  • Outer surface of the uterus
  • Outer surfaces of the bowel
  • Ovaries
  • Fallopian Tubes
  • Other pelvic structures
  • Other body tissues located anywhere in the abdomen

At the time of menses the endometrium at these places proliferates and scar is formed due to internal inflammation.In ovaries chocolate cyst is a sac type collection containing old blood.

What are the Causes of Tuberculosis?

Many theories account to explain the actual causation of endometriosis. Two of the most significant ones are:

Retrograde Menstruation

This theory explains that during menstruation the blood along with some menstrual tissue flows back through the fallopian tube into the pelvic cavity. The endometrial tissue gets implanted there and endometriosis develops. 

Theory of Genetic Transmission

The second theory indicates that endometriosis is a genetic process and is transmitted from one generation to the other in many families.

Other Causes of Endometriosis:

Coelomic Metaplasia

The cells of the pelvic region have some cells that can develop into endometrial tissues causing endometriosis.

Surgery

During episiotomy or a Caesarean Section, the endometrial tissues are transferred to other parts of the body.

What are the Signs and Symptoms of Endometriosis?

Menarche is the onset of menses or periods. It is generally seen that endometriosis develops few years after menarche or the onset of menstruation.

However the signs and symptoms of endometriosis commonly subside with pregnancy and menopause or cessation of menses.

Some commonly seen signs and symptoms of endometriosis are: 

Dysmenorrhoea (Painful Periods)

Painful cramps are seen during the periods. Some women may experience lower backache or lower abdominal pain.

Dyspareunia (Painful Intercourse)

In endometriosis pain during or after having sexual intercourse.

Pain during Maturation

Painful urination is also seen with endometriosis.

Menorrhagia

Excessive or heavy bleeding is also seen with endometriosis. This is due to the increased surface area of endometrium.

Menometrorrhagia

Bleeding during periods is also noticed in many cases.

Infertility

Endometriosis is also noticed in a fertile patient.

Miscellaneous Symptoms

Various symptoms like fatigue, diarrhea, nausea, etc. are also present.

What are the Risk Factors of Endometriosis?

Apart from the above two causative theories some important risk factors of endometriosis are enumerated below:

  • Not producing children
  • Hypomenorrhoea or short menstrual cycle lasting for less than 27 days and heavy bleeding lasting for eight or more days.
  • Medical obstruction preventing outflow of blood
  • Previous history of pelvic inflammation
  • Previous family history (eg. aunts, mother, or sisters suffered the same problem).

How to Diagnose Endometriosis?

On the basis of the symptoms the diagnosis of endometriosis is made.

Laparoscopy, a minor surgical procedure is done to confirm the clinical diagnosis.

Often endometriosis is associated with infertility and is diagnosed during the course of infertility treatment.

What are the Complications of Endometriosis?


Endometriosis is may result in following complications:

Impaired fertility– It is the most common complication of endometriosis. Almost 50-70% of women having endometriosis have problem in becoming pregnant.

The severity of the disease increases with the duration of the disease which means the longer you suffer from endometriosis, greater is the difficulty in conceiving your child.

What are the Treatments for Endometriosis?

As far as the treatment goes there is no sure shot cure available.

Alleviation of the associated symptoms is the only remedy.

The pain involved in intercourse or during menstruation can be relieved by analgesics or pain killers.

Fertility inducing drugs are give to increase the chances of conception.

Certain hormonal medications like contraceptive pills, Lupron, danazol and progesterone are also given by your gynaecologist.

Laparascopy may be done to remove the troubling endometrial tissue. In severe cases hysterectomy with bilateral salpigo-oophrectomy is done to provide relieve.

Endometriosis: FAQs

Here are some of the Frequently Asked Questions about the disease Endometriosis.

Is endometriosis a common disease?

Well the incidence of endometriosis is reported to be quite common in females with menstrual cramps. The percentage of occurrence is 25 to 35 percent.

Is there any particular age group that is susceptible to endometriosis?

Endometriosis is commonly seen to occur in the reproductive period. This means from the onset of puberty till the fertility period.

What are the most obvious symptoms of endometriosis?

The symptoms vary from person to person. However some of the most common symptoms are as under:

  • Pain in lower abdomen
  • Pain during intercourse
  • Pain during periods
  • Infertility

 Why endometriosis results in infertility?

During endometriosis scar tissue is formed in ovaries and tubes. This interferes their normal functioning. The normal physiology of the pelvic organs is disturbed and the egg formation is also adversely affected. Endometrial cyst interferes the process of ovulation. Due to painful coitus the frequency of intercourses is reduced which means the fertilization is also affected. The combine effect is infertility in such females.

Can endometriosis be cured with hysterectomies or pregnancies?

No, these are not the correct cure. A proper medical treatment is the actual cure.

Endometriosis: Glossary

Dyspareunia- Painful intercourse

Menometrorrhagia- Heavy bleeding in between two cycles

Menorrhagia- Heavy blood flow during menstruation

Dysmenorrhoea- Painful menstruation

Chocolate Cyst- When endometrial tissue develops in ovaries, the blood gets accumulated in a cyst like structure known as chocolate cyst of ovary.

Hypomenorrhoea– Scanty menstruation.

References

  • Endometriosis | Office on Women’s Health
    (https://www.womenshealth.gov/a-z-topics/endometriosis)
  • What are the treatments for endometriosis?
    https://www.nichd.nih.gov/health/topics/endometri/conditioninfo/treatment
  • Endometriosis and infertility
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941592/