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Endometriosis?

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What is Endometriosis?

The endometrial tissue (endometrium) forms the lining of the uterus (womb) and is usually shed during the menstrual period. Endometriosis is a non-cancerous condition characterized by the presence of patches of endometrial tissues in areas outside the uterus such as the fallopian tubes, ovaries, bladder or pelvis.

These tissues swell up during the menstrual cycle in a similar way to that within the uterus causing pain and formation of scar tissues.1 Endometriosis has been estimated to affect about 10–15% of menstruating women aged between 25 and 44 years, while it can be observed in teenagers also.  

What are the  Signs and Symptoms of Endometriosis?

A painful menstrual period (dysmenorrhea) in women over the age of 30 years is considered as a characteristic feature of endometriosis.

Abnormal menstrual cycles with variations in blood loss may also be noticed.

Other features include

  • Pain during sexual intercourse
  • Chronic lower abdominal pain that may radiate to groins
  • Hips and thighs (which may exacerbate during menstrual periods), and infertility2, 3

What are the Causes for Endometriosis?

Although the exact cause of endometriosis has not been established, it has been observed to affect the members of the same family giving it a notion of being a hereditary disorder. 

What are the risk factors for endometriosis

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There is an increased risk of its occurrence in

  • women who have their first menstrual period prematurely
  • women whose menstrual cycles are short and heavy
  • women who have their first kid after 30 years of age
  • women who have never conceived

Women who have had multiple pregnancies, who exercise regularly, who consume low dose oral contraceptives are generally at a lower risk.

How is it Diagnosed?

The diagnosis is based on a comprehensive review of the history of pain and other associated symptoms, vaginal examination and specialized investigations such as ultrasound examination and laparoscopy.

What is the Treatment?

Although there is no cure for endometriosis it can be suppressed successfully. The modality of treatment can be medical, surgical or a combination of both the techniques.

The type of treatment is decided depending on the factors such as

  • The age of the patient
  • Presenting complaints
  • The desire to have a child

Along with painkillers certain drugs that can prevent the cyclic changes which occur during menstruation are advised for women, who do not desire to have a child.

Below are some of the commonly advised drugs

  • Oral contraceptives
  • Drugs belonging to the group called progestin
  • Gonadotrophin-releasing hormone agonists
  • Danazol

Surgical treatment

Surgical treatment is advised for women who desire fertility and in women with severe endometriosis.4 Depending on the severity of endometriosis, about 40–70% of women who have undergone surgery may become pregnant .4 Other women may require assisted reproductive techniques to get pregnant.

What are the Complications?

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Endometriosis is not associated with any other complications.

References:

1.Wellbery C. Diagnosis and treatment of endometriosis. Am Fam Physician. 1999; 60(6): 1753–1762, 1767–178.

2.The Merck Manual of Medical of Medical Information. Endometriosis. [homepage on the internet]. Whitehouse Station, NJ: Merck & Co., Inc.; [updated 2007 May; cited 2007 Dec 26]. Available from: http://www.merck.com/mmhe/sec22/ch245/ch245a.html

3.Hart R. Unexplained infertility, endometriosis, and fibroids. . 2003; 327(7417): 721–724.

4.Crosignani P, Olive D, Bergqvist A, et al. Advances in the management of endometriosis: An update for clinicians. Hum Reprod Update. 2006;12(2): 179–189.

Written by: healthplus24.com team

Date last updated: January 19, 2015