Endometriosis

Endometriosis is an incurable but manageable gynecological condition. It occurs when endometrial implants, comprised of tissue normally found within the uterus, are present in other areas of the body. As the tissue continues to thicken, break down, respond to menstrual cycle hormones, and bleed during the menstrual cycle, endometriosis forms deep inside the body. Scar tissue and adhesions form, and this can cause organ fusion and anatomical changes. Endometriosis is thought to affect around 11 percent of women in the United States aged between 15 and 44 years. Symptoms are generally present during the reproductive years. Most women go undiagnosed, and in the U.S. it can take around 10 years to receive a diagnosis. Allergies, asthma, chemical sensitivities, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, breast cancer, and ovarian cancer are linked to women and families with endometriosis. They may affect: the ovaries the fallopian tubes the peritoneum the lymph nodes Normally, this tissue is expelled during menstruation, but displaced tissue cannot do this. This leads to physical symptoms, such as pain. As the lesions grow larger, they can affect bodily functions. For example, the fallopian tubes may be blocked. The pain and other symptoms can affect different areas of life, including the ability to work, medical care costs, and difficulty maintaining relationships. Symptoms Other medical conditions such as pelvic inflammatory disease (PID), ovarian cysts, and irritable bowel syndrome (IBS) can mimic the symptoms of endometriosis. Symptoms of endometriosis include: Severe menstrual cramps, unrelieved with NSAIDS Long-term lower-back and pelvic pain Periods lasting longer than 7 days Heavy menstrual bleeding where the pad or tampon needs changing every 1 to 2 hours Bowel and urinary problems including pain, diarrhea, constipation, and bloating Bloody stool or urine Nausea and vomiting Fatigue Pain during intercourse Spotting or bleeding between periods Pain is the most common indication of endometriosis, but the severity of the pain does not always correlate with the extent of the disease. Pain often resolves following menopause, when the body stops producing estrogen production. However, if hormone therapy is used during menopause, symptoms may persist. Pregnancy may provide temporary relief from symptoms. Complications Complications include: infertility, which can affect 50 percent of those with the condition. increased risk of developing ovarian cancer or endometriosis-associated adenocarcinoma ovarian cysts inflammation scar tissue and adhesion development intestinal and bladder complications It is important to see a health care provider about symptoms, to avoid future complications. Treatment A hysterectomy, or the removal of the uterus, will be considered when all other avenues of treatment have been exhausted. Surgery is possible, but it is normally considered only if other treatments are not effective. Other options include: Pain medications: Either over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) or prescription drugs for the treatment of painful menses. Hormones: Treatment may be with hormonal therapies such as hormonal birth control, Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists, Medroxyprogesterone (Depo-Provera) or Danazol. Placement of an intrauterine device (IUD) may also be recommended. Surgery: Initial surgery will seek to remove the areas of endometriosis, but a hysterectomy with removal of both ovaries may be necessary. Fertility treatment: Pregnancy may be recommended via in-vitro fertilization (IVF).