Endometriosis - Signs, Symptoms And TreatmentEndometriosis (pronounced: en-doe-mee-tree- o -sus) takes its name from the endometrium , the tissue that lines the uterus. Endometriosis is the presence of endometrial tissue outside the lining of the uterine cavity. Ectopic endometrial tissue responds to normal stimulation in the same way as the endometrium, but much less predictably. The endometrial cells respond to estrogen and progesterone with proliferation and secretion. During menstruation, the ectopic tissue bleeds, which causes inflammation of the surrounding tissues. This inflammation causes fibrosis, leading to adhesions that produce pain and infertility. Ectopic tissue is generally confined to the pelvic area, usually around the ovaries, uterovesical peritoneum, uterosacralligaments, and cul-de-sac, but it can appear anywhere in the body.
Active endometriosis may occur at any age, including adolescence. As many as 50% of infertile women may have endometriosis; however, the true incidence in both fertile and infertile women remains unknown.
Severe symptoms of endometriosis may have an abrupt onset or may develop over many years. Infertility occurs in 30% to 40% of women with endometriosis. Endometriosis usually manifests during the menstrual years; after menopause, it tends to subside. Endometriosis affects more than 5 million American women, including teen girls. It's not always diagnosed right away in teens because at first they or their doctors assume that their painful periods are a normal part of menstruating. But continuing, excessive pain that limits activity isn't normal and should always be taken seriously. Because severe endometriosis can make it complicated for a girl to have children in the future, it's a good idea to get medical help for endometriosis and not wait too long.
What causes Endometriosis ?
The cause of endometriosis remains unknown. The main theories that attempt to explain this disorder (one or more are perhaps true for certain populations of women) include:
Signs and symptoms of Endometriosis
Signs and symptoms of endometriosis Include:
The only definitive way to diagnose endometriosis is through laparoscopy or laparotomy. Pelvic examination may suggest endometriosis or may be unremarkable. Findings that suggest endometriosis include:
Treatment of Endometriosis
Treatment of endometriosis varies according to the stage of the disease and the patient's age and desire to have children. Hormonal treatments of endometriosis (continuous use of hormonal contraceptives, danazol [Danocrinel. and GnRH agonists) are potentially effective in relieving discomfort (hormones stop ovulation, thereby decreasing inflammation and any menstrual tissue that may be distributed throughout the body), although treatment for advanced stages of endometriosis usually isn't as successful because of impaired follicular development. However, nonsurgical treatment of endometriosis generally remains inadequate. Surgery appears more effective to enhance fertility, although definitive class I evidence currently doesn't exist. Pharmacologic and surgical treatment of endometriosis may be beneficial for managing chronic pelvic pain. Conservative therapy for young women who want to have children includes:
No pharmacologic treatment has been shown to cure the disease or be effective in all women. Some disadvantages of non surgical therapy include:
When ovarian masses are present, surgery must rule out cancer. Conservative surgery includes:
Special considerations or prevention
Minor gynecologic procedures are contraindicated immediately before and during menstruation.
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