What is Endometriosis and how can you tell if you have this condition? Do you know the symptoms of endometriosis? Do you know it can affect you and those around you?

What is endometriosis ?

 

Endometriosis is considered the presence of endometrial glands (inside lining of the uterus) outside of the uterus itself. When this tissue is implanted in the pelvic organs or lining of the abdomen or peritoneal organs its called endometriosis. So basically endometriosis can affect internal organs like the bladder, rectum, ureters, small bowel, large bowel, ovaries etc and all other organs in the system, including even the brain ( very rare but has been published in the literature).

What Causes Endometriosis ?

The most common theory for what causes endometriosis is what its called retrograde menstruation. Meaning that some of the blood from your menstrual cycle goes into the fallopian tube (as opposed to exit out of the cervix) and spreads inside the abdomen and other organs. There are other theories, however, no single theory can account for the location of this disease when its found or even how some males have been diagnosed with this condition. Also it doesn’t explain why all females do not get endometriosis since 70 % to 90 % of women have retrograde menstruation. In addition, there is a theory that endometriosis is at least partially a genetic disease since some first degree family members suffer from the same disease.

Endometriosis implants can vary in appearance, size and shape. That is why sometimes its difficult to diagnose it. Endometriosis is diagnosed clinically or surgically, but to have a definitive diagnosis physicians have to take a sample of those implants inside the pelvis (via a surgery called Laparoscopy) and send them to pathology for microscopic examination. Clinically, it can be diagnosed based on the symptoms of the patient and how it responds to hormonal therapy with at least 6 months of therapy. If hormonal therapy diminishes the symptoms, then endometriosis is the most likely scenario or diagnosis.

What are the symptoms of endometriosis?

It can be associated with significant menstrual pain, gastrointestinal symptoms, pain, nausea, vomiting, bloating, abdominal distention etc. Also it has been linked with infertility or subfertile conditions. It however has not been linked to spontaneous abortion or pregnancy losses.

Clinical Examination

In many women with endometriosis, no abnormality is initially detected during a well woman exam. Sometimes on a rectal exam a physician might notice certain nodularities, uterosacral scarring ( ligaments that hold the uterus inside the pelvis) or fixed uterus inside the pelvis.

Is there a test to diagnose endometriosis?

Imaging modalities have been used to detect endometriosis although sometimes are not useful. Ultrasound, transrectal ultrasound, CT scan, MRI etc have been used however some of them cannot be used as primary diagnostic tools because of their cost.

There is no specific blood test available for the diagnosis of endometriosis, however when a diagnosis have been made by tissue sampling during laparoscopy, a protein called CA125 have been used to monitor endometriosis after therapy. ( Laparsocopy is the standard for visualization of endometriosis implants inside the pelvis and abdomen)

Can I prevent endometriosis ?

No strategies have been successful. Some theories have been mentioned in the past that women who engage in regular aerobic activities from early age have a somewhat protective effect. However this has not been investigated completely. Most of the time, in 30 to 60% of cases endometriosis progresses to a more severe stage after a year of diagnosis, and its not possible even to predict who will have a progression of the disease.

What are the therapies for endometriosis?

1)Surgical treatment:

The goal is to remove all visible lesions in the pelvis or abdomen, including the ovaries, peritoneum, rectum etc. With surgery you can even remove the adhesions that this diease creates inside the pelvic organs.

Other surgical alternatives, after finishing reproductive life is to remove the ovaries and the uterus ( the organs that most likely caused the endometriosis in the first place).

2)Non Hormonal therapy:

Pain medications like NSAIDs {Non steroidal anti-inflamatory drugs:  Naproxen, Ibuprofen, Aleve etc) can decreased the pain during your period caused by endometriosis. This are common methods that probably all women use for when having painful menses.

3)Hormonal therapy:

Continuous oral contraceptives ( for 90 days or more) and non continuous oral contraceptives ( for 28 days or cyclic administration). Progestins ( Provera ir even depo-Provera , used for contraception) can be used to treat endometriosis.

4)Gonadotropin releasing hormones:

These hormones attach to receptors inside the brain and decrease some hormones that affect the production of ovarian hormones and eventually decreases endometriosis implants. Side effect of this medication are similar to being menopausal, since it decreases the amount of estrogen levels  in you system to very low levels or undetectable levels.

 

 

 

 

There are other medications that can be used and other medical and non medical alternatives  that can be used with  a patient with endometriosis, so if you think you have this condition, talk to your doctor / OBGYN about it or book an appointment with Pink Women’s Center.

Follow

Joel Rivera on Google+!