Endometriosis has no known cure but can be managed

MARCH is observed internationally as Endometriosis Awareness Month, a month during which efforts are made to increase awareness of this condition, its symptoms and the effect it has on the lives of women who suffer from it.

Endometriosis is a disorder characterised by tissue which is similar to that which lines the uterus but which grows outside the uterine cavity. The lining of the uterus is called the endometrium.

This disorder is a common gynaecological condition that affects up to 10% of women across the globe. The endometrial tissue may grow on your ovaries, bowel or the lining of your pelvis. It is unusual for endometrial tissue to spread beyond your pelvic region but not impossible.

Endometrial tissue growing outside of your uterus is known as an endometrial implant. The hormonal changes of your menstrual cycle affect the misplaced endometrial tissue causing the area to become inflamed and painful. This means the tissue will grow, thicken and break down. Over time, the tissue that has broken down has nowhere to go and becomes trapped in your pelvis. This tissue trapped in your pelvis can cause irritation, scar formation, adhesions where tissue binds your pelvic organs together, severe pain during your periods and fertility problems.

Awareness

While medical conditions such as cancer, HIV and autism are well known and combating them attracts funding from various organisations, endometriosis is not a widely publicised condition. Many people, women included, have never heard of it. Yet about one in 10 women suffers from it.

The awareness month is intended not only to increase awareness and knowledge of this condition but to help women living with this incurable condition to recognise its symptoms so that they can find out more about it, take steps to find out from their doctor or clinic whether they may be suffering from it and learn how to manage the symptoms.

In some countries a range of awareness events are held during this month, including marches to help raise money for medical research to search for a cure. Some people wear yellow clothes or a yellow ribbon as part of the awareness campaign.

Causes

The exact cause of endometriosis is unknown. There are several theories regarding the cause, although no one theory has been scientifically proved.

One of the oldest theories is that endometriosis occurs due to a process called retrograde menstruation. This happens when menstrual blood flows back through your fallopian tubes into your pelvic cavity instead of leaving your body through the vagina. Another theory is that hormones transform the cells outside the uterus into cells similar to those lining the inside of the uterus, known as endometrial cells.

Others believe the condition may occur if small areas of your abdomen convert into endometrial tissue. This may happen because cells in your abdomen grow from embryonic cells, which can change shape and act like endometrial cells. It is not known why this occurs.

These displaced endometrial cells may be on your pelvic walls and the surfaces of your pelvic organs, such as your bladder, ovaries and rectum. They continue to grow, thicken and bleed over the course of your menstrual cycle in response to the hormones of your cycle. It is also possible for the menstrual blood to leak into the pelvic cavity through a surgical scar such as one left after delivering a baby through a caesarean (C-section) operation.

Symptoms

The symptoms of endometriosis vary. Some women experience mild symptoms while others can have moderate to severe symptoms. The severity of your pain does not indicate the degree or stage of the condition. You may have a mild form of the disease yet experience agonising pain. It is also possible to have a severe form and have little discomfort.

Pelvic pain is the most common symptom of endometriosis. You may also experience painful periods, pain in the lower abdomen before and during menstruation, cramps one or two weeks around menstruation as well as heavy menstrual bleeding or bleeding between periods.

Other symptoms include pain after sexual intercourse, discomfort with bowel movements and lower back pain that may occur at any time during your menstrual cycle. In some cases you may have no symptoms at all. Regular gynaecological examinations will allow your gynaecologist to monitor any changes, particularly if you have two or more symptoms.

Treatment

Endometriosis has no cure but its symptoms can be managed. The condition, if left untreated, can disrupt your life, so finding quick relief from pain and other symptoms is crucial.

Medical and surgical options are available to help reduce symptoms and manage any potential complications. Your doctor may start off with conservative treatment. If this fails, the doctor may recommend surgery.

Individuals with endometriosis react differently to the treatment options available. Your doctor will help you decide on the one that works best for you. Treatment options include taking non-prescription pain medication such as ibuprofen. This may not, however, be effective in all cases.

Hormone therapy can also be used. Taking supplemental hormones can sometimes relieve pain and stop the progression of endometriosis. Hormone therapy helps the body regulate monthly hormonal changes that promote the tissue growth that occurs with endometriosis.

Hormonal contraceptives can also be taken. They decrease fertility by preventing the monthly growth and build-up of endometrial tissue. Birth control pills, patches and vaginal rings can reduce or even eliminate the pain in less severe cases of endometriosis.

The medroxyprogesterone (Depo-Provera) injection is also effective in stopping menstruation. It stops the growth of endometrial implants. It also relieves pain and other symptoms. This may not be the best first choice because of the risk of decreased bone production, weight gain and an increased incidence of depression in some cases.

Conservative surgery is another option for women who want to get pregnant or experience severe pain when hormonal treatments are not working. The goal of conservative surgery is to remove or destroy endometrial growths without damaging the reproductive organs.

The information in this article is provided as a public service by the Cimas iGo Wellness programme, which is designed to promote good health. It is provided for general information only and should not be construed as medical advice. Readers should consult their doctor or clinic on any matter related to their health or the treatment of any health problem. — igo@cimas.co.zw or WhatsApp 0772 161 829 or phone 024-2773 0663.