What you need to know about Endometriosis

2022-03-08

Endometriosis is a common gynaecological condition where the tissue similar to that seen in the uterus lining starts to develop in other parts of the female reproductive organs such as the ovaries, fallopian tubes and outside of the uterus. The term of this condition originates from the word "endometrium," which is the tissue that lines the uterus. This condition affects approximately 10-15 percents women of reproductive age1.

Symptoms of Endometriosis

  1. Chronic pelvic pain, particularly during your menstrual period.

  2. Menstrual changes such as severe cramps (dysmenorrhea) and increased bleeding.

  3. Pain when urinating and during bowel movements, particularly during menstruation. 

  4. Diarrhoea, constipation, and nausea.

  5. Pain during sex (Dyspareunia).

  6. Pain while exercising.

Stages of Endometriosis

Stage One:  Relatively small, superficial outbreaks of the condition.

Stage Two: Deep lesions in the pelvic area.

Stage Three: Deep lesions within the pelvic area including the ovaries

Stage Four: Deep, extensive lesions and adhesions throughout the pelvic area and outside the region.

 

What are the causes of endometriosis?

Some of the causes of this condition include:

  • Retrograde menstruation: This is when instead of menstrual blood flowing through the cervix and out of the vagina, the blood and tissue rather flows upwards through the vagina into the fallopian tubes and exits through the peritoneum.
  • Lymphatic spread: It occurs when endometrium cells spread throughout the body via the bloodstream or lymphatic system.
  • Genetics: A recent study by Oxford University found that the protein coding gene NPSR1 increases risk of suffering from endometriosis2.

 

What are the health risks?

Infertility: About 30-40% of women with this condition become infertile. Adhesions can make the fallopian tubes to close which inhibit the flow of eggs to the uterus and endometriomas. Endometriomas (fluid filled cysts) in the ovaries can also cause inflammation, damage eggs, and block ovulation.

Mental health: Women with endometriosis are more likely to develop anxiety and depression.

Diagnosis and Treatments

The methods to diagnose this condition include:

  • Laparoscopy: This is the most reliable way to diagnose and it involves a small camera being used to investigate the abdomen for signs of endometriosis.
  • Pelvic Ultrasound: This method involves using an ultrasound scan on the pelvic area to check for existence, severity and spread of endometriosis.

If you think you may have some of the symptoms listed above, you should contact your healthcare provider and arrange an appointment so that the pelvic area can be looked at for endometriosis. Having this condition can be daunting; still there are several ways in which the debilitating pain of this illness can be reduced. These include:

Birth control

  • Contraceptive pill: It helps reduce endometrial build up and excessive bleeding. The tissues react to the hormonal changes during the menstrual cycle so controlling these hormones reduces the pain – preventing ovulation lowers the levels of estrogen and progesterone (which thicken the endometrium).
  • Progesterone or Mirena coil: This will help with cyclical pain but not pain from pre-existing adhesions and lesions.

Surgery

  1. Removal of endometriosis: Endometrial tissue, adhesions, scar tissue and cysts can be surgically removed so that the pelvic area can be returned as close to its natural state as possible.
  2. Hysterectomy: This involves the complete surgical removal of the uterus.
  3. Oophorectomy: This procedure involves the complete removal of the ovaries.
  4. Medically induced menopause: This can aid with reducing symptoms by stopping the menstrual cycle.

Written by: George Hatton