Our thanks to the charity Endometriosis UK for their contribution to this weeks report and for the use of the material below, for more detailed information, help and support follow this link http://www.endometriosis-uk.org/
What is it? - Endometriosis is the name given to the condition where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body.
Every month your body goes through hormonal changes. You naturally release hormones which cause the lining of the womb to increase in preparation for a fertilised egg. If pregnancy does not occur, this lining will break down and bleed. The blood is then released from your body as a period.
Endometriosis cells react in the same way – except that they are located outside your womb. During your monthly cycle your hormones stimulate the endometriosis, causing it to grow, then break down and bleed. This internal bleeding, unlike a period, has no way of leaving the body. This leads to inflammation, pain, and the formation of scar tissue (adhesions). Endometrial tissue can also be found in the ovary, where it can form cysts, called ‘chocolate cysts’ because of their appearance.
The cause of endometriosis is unknown:- One theory is that the endometrial tissue is deposited in unusual locations by the backing up of menstrual flow into the Fallopian tubes and the pelvic and abdominal cavity during menstruation (termed retrograde menstruation). The cause of retrograde menstruation is not clearly understood. But retrograde menstruation cannot be the sole cause of endometriosis. Many women have retrograde menstruation in varying degrees, yet not all of them develop endometriosis.
Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. (This process is termed coelomic metaplasia.)
It is also likely that direct transfer of endometrial tissues during surgery may be responsible for the endometriosis implants sometimes seen in surgical scars (for example, episiotomy or Cesarean section scars). Transfer of endometrial cells via the bloodstream or lymphatic system is the most likely explanation for the rare cases of endometriosis that develop in the brain and other organs distant from the pelvis.
Finally, some studies have shown alternations in the immune response in women with endometriosis, which may affect the body's natural ability to recognize and destroy any misdirected growth of endometrial tissue.
Some women experience symptoms while others do not. The symptoms of endometriosis can vary in intensity.
Common symptoms
The amount of endometriosis does not always correspond to the amount of pain and discomfort. A small amount of endometriosis can be more painful than severe disease. It depends, largely, where the endometriosis is actually growing inside the body.
All of the symptoms above may have other causes. It is important to seek medical advice to clarify the cause of any symptoms you may experience. If your symptoms change after diagnosis it is important to discuss these changes with a medical practitioner. It is easy to attribute all your problems to endometriosis but it may not always be the cause of your symptoms.
Diagnosis:- Endometriosis can be suspected based on symptoms of pelvic pain and findings during physical examinations in the doctor's office. Occasionally, during a rectovaginal exam (one finger in the vagina and one finger in the rectum), the doctor can feel nodules (endometrial implants) behind the uterus and along the ligaments that attach to the pelvic wall. At other times, no nodules are felt, but the examination itself causes unusual pain or discomfort.
Unfortunately, neither the symptoms nor the physical examinations can be relied upon to conclusively establish the diagnosis of endometriosis. Imaging studies, such as ultrasound, can be helpful in ruling out other pelvic diseases and may suggest the presence of endometriosis in the vaginal and bladder areas, but still cannot definitively diagnose endometriosis. For an accurate diagnosis, a direct visual inspection inside of the pelvis and abdomen, as well as tissue biopsy of the implants are necessary.
As a result, the only accurate way of diagnosing endometriosis is at the time of surgery, either by opening the belly with large-incision laparotomy or small-incision laparoscopy.
Treatment: - Sadly, there is currently no cure for endometriosis. The different treatments available aim to reduce the severity of symptoms and improve the quality of life for a woman living with the condition. The type of treatment should be decided in partnership between her and her healthcare professional. The decision about which treatment to choose should depend on several factors:
The treatments currently available can help by relieving pain symptoms; shrinking or slowing endometriosis growth; preserving or restoring fertility; or preventing/delaying the recurrence of the disease.
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