Endometriosis

Endometriosis is a common gynecological disease. It causes many problems and some of its forms may be even dangerous. The name endometriosis comes from the word endometrium.

 

The name endometriosis comes from the word endometrium, the mucosa of the womb. The mucosa is a subject of regular periodic changes due to changes of female sex hormones levels – estrogen and progesterone. During the menstrual cycle, the endometrium grows and prepares for the implantation of the fertilized egg. If that does not happen, the distal layers of the mucosa succumb to necrosis, bleeding from local blood vessels occurs and the necrotic cells are washed away with the menstrual blood.

 

The endometriosis means that areas of the uterine mucosa occur elsewhere in the body. It sounds odd but it is proven that endometriosis may affect practically every tissue and organ of the body (the fallopian tubes, abdominal cavity, lungs, brain, etc.). Spleen is the only organ, where endometriosis has never been proven and the reason is unclear. The most commonly affected are fallopian tubes, ovaries and the pelvic peritoneum.

Causes

In is uncertain how the edometrium tissue gets outside of the uterus. There are more theories that try to answer this question. Many physicians assume that endometriosis is related to a backflow of menstrual blood to fallopian tubes and through the tubes into the abdominal cavity. The remnants of the uterine lining are taken with the menstrual blood and they are attached to the wall of the fallopian tube or peritoneum (the membrane lining the abdominal cavity). This theory, however, does not explain satisfactorily why the endometrium may occur elsewhere in the body.

Symptoms

Endometriosis has many possible signs. The most typical symptom is abdominal pain located in pelvic are that occurs during menstruation. Endometriosis can cause also pain during intercourse and in number of women even infertility. The exact relationship between endometriosis and infertility is still under investigation. Endometriosis is accompanied with noninfectious inflammation causing scarring and formation of adhesions. These changes may impair or totally prevent fertilization and transport of the fertilized egg to the uterus. It is also assumed that endometriosis is related to a hormonal imbalance further increasing the risk of infertility. Bleeding is another problem of endometriosis, especially when some organs are affected. The areas of endometriosis respond to hormonal changes of menstrual cycle and tend to bleed during monthly menstruation period. Lung endometriosis can therefore cause coughing up blood, endometriosis of the urinary bladder may be accompanied by blood in urine, etc. When the blood can not flow away, it accumulates and forms cystic formations.

As you surely noticed, most symptoms of endometriosis are associated with menstrual cycle and occur in the menstruation period.

Diagnosis

The diagnosis is suspicious in women with some of the above mentioned problems, usually when associated with their menstrual cycle. The woman should be examined by a gynecologist including medical history, physical examination and eventually abdominal ultrasound or hysteroscopy. When there is a suspicion of peritoneal endometriosis, it is often necessary to perform a diagnostic laparoscopy. Laparoscopy allows to visualize the inside of the abdominal cavity, discover any present areas of endometriosis (visible as reddish irritated spots) and to take biopsy samples to confirm the diagnosis. Endometriosis in other organs may be diagnosed by other imaging methods including computed tomography but the proper diagnosis must be always stated based on positive histological examination of an obtained sample.

Treatment

The treatment is executed by gynecologist. Pharmacotherapy consists mainly of hormonal preparations that cause cessation of menstruation and help to reduce the deposits of endometriosis. Any found and accessible areas of endometriosis may be destroyed by physical methods such as laser or electric coagulation.