ENDOMETRIOSIS

Statistically, endometriosis affects an estimated 10% of women world-wide. This is an estimated 200 million women globally. About 25-50% of the women who are infertile have endometriosis, and 30-50% of those with endometriosis are infertile. March is considered endometriosis awareness month symbolized with a yellow ribbon.

Endometriosis is a gynaecological condition in which tissue similar to the endometrium (tissue that forms the lining of the uterus) grows outside of the uterus. The endometrium normally grows in the womb to prepare the lining of the womb/ uterus for ovulation. This tissue consists of blood cells, connective tissues and glands. The build ups of this tissue, endometrial tissue, outside the uterus are known as endometrial implants that cause endometriosis. Endometriosis can affect the ovaries, fallopian tubes, peritoneum (a thin membrane lining the abdominal cavity) and lymph nodes. It can also affect areas beyond the pelvic region. Normally during menstruation, the endometrium is usually expelled from the womb however, the endometrial implant cannot be expelled making them grow, thicken and break down but with nowhere to go, the broken-down tissues get trapped in the pelvis causing irritation, formation of scars, severe menstrual pain and the tissue binds with your pelvic organs.

Causes of endometriosis.

The causes of endometriosis are unknown however there are some theories yet to be proven right suggesting otherwise. For example;

  • Retrograde menstruation which is a process that happens when menstrual blood flows back through the oviduct/ fallopian tubes into your pelvic cavity instead of leaving the body through the vagina.
  • Another theory is that endometriosis is caused due to a surgical scar implantation after a surgery such as a C-section. Also,
  • An immunity disorder where your immunity system fails to recognize and destroy the endometrial implants outside the womb.

Symptoms of endometriosis.

The symptoms associated with endometriosis vary from woman to woman in that some women may experience mild symptoms; others moderate, others severe symptoms. It is also important to note that other medical conditions like; irritable bowel syndrome, ovarian cysts and pelvic inflammation disease, mimic the symptoms of endometriosis hence advised to see a health care provider for further diagnosis.

  • The most common symptom associated with endometriosis is pelvic pain. Others are;
  • Heavy menstrual bleeding
  • Pain and discomfort with bowel movements and urination
  • Severe menstrual pain
  • Periods lasting more than 7 days
  • Nausea and vomiting
  • Fatigue
  • Lower back pain
  • Pain during intercourse
  • Spotting or bleeding in between periods

Endometriosis complications.

This condition increases the risk of developing scar tissues and endo adhesions (thick bands of scar tissues that binds organs together), ovarian cancer, intestinal and bladder complications, ovarian cysts and infertility. Statistics show that between 30 and 50% of women with infertility will have endometriosis. Infertility comes about when this condition causes distortion of the fallopian tubes making them unable to take up or collect the egg after ovulation or by creating an inflammation that adversely affects the functions of the ovaries, oviduct, eggs and womb.

Diagnosis.

Due to the similar symptoms with other medical conditions, it is easy for someone to get the wrong diagnosis. In order to properly diagnose endometriosis, a laparoscopy is to be performed. This is a minimally invasive surgery a doctor performs to look in the abdomen with a camera through the belly button in order to visualize and diagnose endometriosis lesions which vary in appearance.

An endometriosis diagnosis can be classified in stages i.e.

Stage 1/minimal stage- minimal and isolated lesions can be seen

Stage 2/ mild stage- mild lesions with a possibility of adhesions forming

Stage3/moderate stage- moderate lesions that are deep with clear adhesions that have formed

Stage 4/ severe stage- multiple and severe lesions that are both deep and shallow with noticeable adhesions

Treatments.

Endometriosis has no cure but can be managed with the help of your doctor who can prescribe the right treatments for you. Treatment options include;

  1. Pain medications to relive the pain and discomfort.
  2. Hormonal therapy which includes; taking hormonal birth control which reduces fertility and prevent the monthly growth of the endometrium, taking Danazol a medication which stops menstruation therefore reducing the symptoms however, endometriosis will continue to progress and also some women get to be prescribed the so called,’Gonadotropin-releasimg hormone (GnRH) agonists and antagonists which block the production of estrogen which stimulates the ovaries and creates an artificial menopause meaning no menstruation.
  3. Undergoing surgery; the first type of surgery is known as a conservative surgery which is perfect for women with endometriosis who want to be pregnant. This surgery is also for those whom neither the hormonal therapies nor the pain medication is working. This surgery is mainly to remove the endometrial implants without causing harm or damage to the reproductive organs. A laparoscopy is done here this time not to diagnose but to remove the endometrial tissues.

The second type of surgery is the last resort if the other treatments are not working. A hysterectomy; a surgery where the surgeon removes the uterus, cervix, ovaries and all implant lesions. This is not considered a cure for endometriosis because once you undergo this kind of treatment, you can never get pregnant.

It is possible for one to get pregnant and have a healthy baby with endometriosis. However, having endometriosis makes it difficult for one to conceive than women without the condition. Pregnant women with endometriosis are considered high risk. There are a couple of myths surrounding the symptoms of endometriosis.

Myth; you cannot get endometriosis when you are young. The truth is that, the condition can appear in a growing foetus but reaching the reproductive age, the estrogen levels trigger the symptoms.

Myth; severe menstrual pain is normal. The truth is that severe pain may be caused by an underlying condition

Myth; heavy menstrual bleeding means that you have the condition. Truth is that other medical conditions can cause heavy bleeding.

If you happen to have similar symptoms, do not feel ashamed and ignore your symptoms. Go to your doctor to get checked, get a diagnosis and advised on the necessary steps to take.