] ] What is en­dometrio­sis?


have not been able to con­ceive for many years and also suf­fer from bleed­ing and pains. Af­ter thor­ough in­ves­ti­ga­tions, I was in­formed that I am suf­fer­ing from En­dometrio­sis. Please shed some light on it?

Billy X

The en­dometrium is the tis­sue that lines the in­side of the womb (uterus). En­dometrio­sis is a con­di­tion where en­dome­trial tis­sue is found out­side the uterus. It is ‘trapped’ in the pelvic area and lower tummy (ab­domen) and, rarely, in other ar­eas in the body.

Who gets en­dometrio­sis?

The ex­act num­ber of women who de­velop en­dometrio­sis is not known. This is be­cause many women have en­dometrio­sis with­out symp­toms, or with mild symp­toms, and are never di­ag­nosed. In­ves­ti­ga­tions to di­ag­nose en­dometrio­sis are only done if symp­toms be­come trou­ble­some and are not eased by ini­tial treat­ments. Es­ti­mates vary so that from about 1 in 10 to as many as 5 in 10 of all women de­velop some de­gree of en­dometrio­sis. En­dometrio­sis can af­fect any woman. How­ever some­times it runs in fam­i­lies.

What causes en­dometrio­sis?

The ex­act cause is not known. It is thought that some cells from the womb (uterus) lin­ing (the en­dometrium) get out­side the uterus into the pelvic area. They get there by spilling back­wards along the Fal­lop­ian tubes when one has a pe­riod. The ‘spilt’ en­dome­trial cells then con­tinue to sur­vive next to the uterus, ovary, blad­der, bowel, or Fal­lop­ian tube. The cells re­spond to the fe­male hor­mone oe­stro­gen, just like the lin­ing of the uterus does each month. Through­out each month the cells mul­ti­ply and swell, and then break down as if ready to be shed at the time of your pe­riod. How­ever, be­cause they are trapped in­side the pelvic area, they can­not es­cape. They form patches of tis­sue called en­dometrio­sis.

What are the symp­toms of en­dometrio­sis?

1. Painful pe­ri­ods; the pain typ­i­cally be­gins a few days be­fore the pe­riod and usu­ally lasts the whole of the pe­riod. 2. Painful sex. 3. Pain in the lower ab­domen and pelvic area.

4. Other men­strual symp­toms may oc­cur. For ex­am­ple, bleed­ing in be­tween pe­ri­ods.

5. Dif­fi­culty be­com­ing preg­nant (re­duced fer­til­ity).

6. Un­com­mon symp­toms in­clude pain on pass­ing poo (fae­ces), pain in the lower tummy (ab­domen) when you pass urine, and, very rarely, blood in the urine or fae­ces.

How is the di­ag­no­sis of en­dometrio­sis con­firmed?

The symp­toms caused by en­dometrio­sis can be caused by other con­di­tions. There­fore, if any of the above symp­toms be­come per­sis­tent then tests are usu­ally ad­vised to find the cause of the symp­toms. En­dometrio­sis is usu­ally con­firmed by a la­paroscopy. This is a small oper­a­tion that in­volves mak­ing a small cut, un­der anaes­thetic, in the tummy (ab­dom­i­nal) wall be­low the tummy but­ton (um­bili­cus). A thin te­le­scope-like in­stru­ment (a la­paro­scope) is pushed through the skin to look in­side. Patches of en­dometrio­sis can be seen by the doc­tor.

How does en­dometrio­sis progress?

1. If en­dometrio­sis is left un­treated, it be­comes worse in about 4 in 10 cases. It gets bet­ter with­out treat­ment in about 3 in 10 cases. For the rest it stays about the same. En­dometrio­sis is not a can­cer­ous con­di­tion.

2. Com­pli­ca­tions some­times oc­cur in women with se­vere un­treated en­dometrio­sis. For ex­am­ple, large patches of en­dometrio­sis can some­times cause a block­age (ob­struc­tion) of the bowel or of the tube from the kid­ney to the blad­der (the ureter).

Treat­ment op­tions

1. Not treat­ing as an op­tion; if symp­toms are mild and fer­til­ity is not an is­sue for you then you may not want any treat­ment. In about 3 in 10 cases, en­dometrio­sis clears and symp­toms go with­out any treat­ment.

2. Painkillers for en­dometrio­sis; Parac­eta­mol taken dur­ing pe­ri­ods may be all that you need if symp­toms are mild.

3. Anti – in­flam­ma­tory painkillers may be bet­ter than parac­eta­mol.

4. Other op­tions are hor­mone treat­ment or surgery for en­dometrio­sis.

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