HappyKids - Premium Children HTML Template

Endometriosis

Signs and symptoms

A major symptom of endometriosis is recurring pelvic pain. The pain can range from mild to severe cramping that occurs on both sides of the pelvis, in the lower back and rectal area, and even down the legs. The amount of pain a woman feels correlates poorly with the extent or stage (1 through 4) of endometriosis, with some women having little or no pain despite having extensive endometriosis or endometriosis with scarring, while other women may have severe pain even though they have only a few small areas of endometriosis. Symptoms of endometriosis-related pain may include:

Throbbing, gnawing, and dragging pain to the legs are reported more commonly by women with endometriosis. Compared with women with superficial endometriosis, those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down.citation needed Individual pain areas and pain intensity appears to be unrelated to the surgical diagnosis, and the area of pain unrelated to area of endometriosis

Endometriosis lesions react to hormonal stimulation and may "bleed" at the time of menstruation. The blood accumulates locally, causes swelling, and triggers inflammatory responses with the activation of cytokines. This process may cause pain. Pain can also occur from adhesions (internal scar tissue) binding internal organs to each other, causing organ dislocation. Fallopian tubes, ovaries, the uterus, the bowels, and the bladder can be bound together in ways that are painful on a daily basis, not just during menstrual periods.citation needed

Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some women, become independent of the disease itself.

Fertility

Many women with < infertility may have endometriosis. As endometriosis can lead to anatomical distortions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury), the causality may be easy to understand; however, the link between infertility and endometriosis remains enigmatic when the extent of endometriosis is limited. It has been suggested that endometriotic lesions release factors which are detrimental to gametes or embryos, or, alternatively, endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon; for this reason it is preferable to speak of endometriosis-associated infertility.

Other

Other symptoms include constipation and chronic fatigue.In addition to pain during menstruation, the pain of endometriosis can occur at other times of the month. There can be pain with ovulation, pain associated with adhesions, pain caused by inflammation in the pelvic cavity, pain during bowel movements and urination, during general bodily movement like exercise, pain from standing or walking, and pain with intercourse. But the most desperate pain is usually with menstruation and many women dread having their periods. Pain can also start a week before menses, during and even a week after menses, or it can be constant. There is no known cure for endometriosis.

Current research has demonstrated an association between endometriosis and certain types of cancers, notably some types of ovarian cancer, non-Hodgkin's lymphoma and brain cancer. Despite similarities in their name and location, endometriosis bears no relationship to endometrial cancer

Endometriosis often also coexists with leiomyoma or adenomyosis, as well as autoimmune disorders. A 1988 survey conducted in the US found significantly more hypothyroidism, fibromyalgia, chronic fatigue syndrome, autoimmune diseases, allergies and asthma in women with endometriosis compared to the general population.

Complications

Complications of endometriosis include internal scarring, adhesions, pelvic cysts, chocolate cyst of ovaries, ruptured cysts, and bowel and ureteral obstruction resulting from pelvic adhesions.[citation needed] Infertility can be related to scar formation and anatomical distortions due to the endometriosis; however, endometriosis may also interfere in more subtle ways: cytokines and other chemical agents may be released that interfere with reproduction.[citation needed] Peritonitis from bowel perforation can occur

Ovarian endometriosis may complicate pregnancy by decidualization, abscess and/or rupture.

Pleural implantations are associated with recurrent right pneumothoraces at times of menses, termed catamenial pneumothorax


Location and classification

500x500_1

Endometriosis is a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the membrane which lines the abdominal cavity. The uterine cavity is lined with endometrial cells,

which are under the influence of female hormones. Endometrial-like cells in areas outside the uterus (endometriosis) are influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms often worsen with the menstrual cycle.

Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 6–10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations. Endometriosis is a common finding in women with infertility.

There is no cure for endometriosis, but it can be treated in a variety of ways, including pain medication, hormonal treatments, and surgery.

Treatment

Treatment depends on the following factors:

  • Age
  • Severity of symptoms
  • Severity of disease
  • Whether you want children in the future

If you have mild symptoms and do not ever want children, you may choose to have regular exams every 6 - 12 months so the doctor can make sure the disease isn't getting worse. You can manage your symptoms by using:

  • Exercise and relaxation techniques
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), acetaminophen (Tylenol), or prescription painkillers to relieve cramping and pain.

Treatment to stop the endometriosis from getting worse often involves using birth control pills continuously for 6 - 9 months to stop you from having periods and create a pregnancy-like state. This is called pseudopregnancy. This therapy uses estrogen and progesterone birth control pills. It relieves most endometriosis symptoms. However, it does not prevent scarring or reverse physical changes that have already occurred as the result of the endometriosis.

Other hormonal treatments may include:

  • Progesterone pills or injections. However, side effects can be bothersome and include weight gain and depression.
  • Gonadotropin-agonist medications such as nafarelin acetate (Synarel) and Depo Lupron to stop the ovaries from producing estrogen and produce a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment is usually limited to 6 months because it can lead to bone density loss. It may be extended up to 1 year in some cases.

Other hormonal treatments may include:

  • Progesterone pills or injections. However, side effects can be bothersome and include weight gain and depression.
  • Gonadotropin-agonist medications such as nafarelin acetate (Synarel) and Depo Lupron to stop the ovaries from producing estrogen and produce a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes. Treatment is usually limited to 6 months because it can lead to bone density loss. It may be extended up to 1 year in some cases.

Surgery may be recommended if you have severe pain that does not get better with other treatments. Surgery may include:

  • Pelvic laparoscopy or laparotomy to diagnose endometriosis and remove all endometrial implants and scar tissue (adhesions).
  • Hysterectomy to remove the womb (uterus) if you have severe symptoms and do not want to have children in the future. One or both ovaries and fallopian tubes may also be removed. If you do not have both of ovaries removed at the time of hysterectomy, your symptoms may return.

Medication

A number of medications are in use to control symptoms caused by fibroids. NSAIDs can be used to reduce painful menses. Oral contraceptive pills are prescribed to reduce uterine bleeding and cramps. Anemia may have to be treated with iron supplementation. Levonorgestrel intrauterine devices are highly effective in limiting menstrual blood flow and improving other symptoms. Side effects are typically very moderate because the levonorgestrel (a progestin) is released in low concentration locally. There is now substantial evidence that Levongestrel-IUDs provide good symptomatic relief for women with fibroids. While most Levongestrel-IUD studies concentrated on treatment of women without fibroids a few reported very good results specifically for women with fibroids including a substantial regression of fibroids.

Recent Posts