Endometriosis is a situation where the tissues that line the walls of the uterus abnormally grow outside the uterus. This abnormal growth within the pelvic areas affects the fallopian tubes, ovaries, and tissues around the ovaries and uterus, such as the lymph nodes. Sometimes, endometriosis extends outside the pelvic area to other parts of the body.
About 3-10%of women of reproductive age worldwide are affected by endometriosis.
Symptoms of Endometriosis
- Chronic pelvic or lower abdominal pain
- Painful menstruation
- Painful sexual intercourse,
- Difficulty conceiving
- Painful bowel movement
- Blood in the urine or painful urination
- Abnormal, heavy vaginal bleeding
However, about 20-25% of women with endometriosis have no symptoms.
NOTE: (I) Symptoms are generally present during reproductive years.
(ii) In some cases, conditions/diseases such as allergies, asthma, auto-immune diseases, chronic fatigue syndrome, fibromyalgia, breast cancer and ovarian cancer are linked with endometriosis
Causes of Endometriosis
The cause of endometriosis is not actually known, but certain factors are linked with it.
- Retrograde menstruation
Retrograde menstruation is a situation where menstrual blood flows through the fallopian tubes into the abdominal cavity instead of flowing through the vagina as in a normal situation.
- Genetic factor
Genes that influence endometriosis may be transferred from affected women to their offspring.
- It is also suspected that cells from the lining of the uterus (endometrium) travel through the blood vessels or the lymphatic system to reach other organs or parts of the body.
Does Endometriosis cause infertility?
Yes, endometriosis does cause infertility. About 20-40% of women with infertility problem have endometriosis.
How does Endometriosis cause infertility?
The wall or lining of the uterus usually thickens during a woman’s monthly cycle in readiness for the implantation of fertilized egg (or foetus). However, if no implantation takes place, the thickened wall breaks down and bleeds. This bleeding (menstrual blood or flow) is flushed out through the vagina.
Consequently, when the wall or lining of the uterus grows outside the uterus, e.g. on the fallopian tubes, ovary, bladder, bowels, etc (as in the case in endometriosis), they also thicken in the same way as those within the uterus in response to the monthly cycle. This thickened wall or lining also breaks down and bleeds. However, instead of being flushed out through the vagina, the menstrual blood spills on organs, especially those within the pelvis area; it also result in the formation of scar tissue and adhesion. This causes:
- endometrial cyst (or endometrioma or ovarian endometrioma) to form within or on the ovary. This affects the proper functioning of the ovary, difficulty in getting pregnant, raising risk of ovarian cancer, and pelvic pain.
- inflammation, irritation and pain that affect the proper functioning of the ovaries, egg, fallopian tubes, or uterus.
- blockage of the fallopian tubes as a result of endometrial lesions
- inability of the fallopian tubes to pick up egg after ovulation.
- scar tissue and adhesion (sticky substance) to form, which cause organs to fuse together, thus shifting their positions and creating anatomical distortion or change.
How is Endometriosis diagnosed?
Endometriosis is diagnosed through
This is a simple surgery of inserting a tiny camera called laparoscope through a cut on the belly in order to examine the pelvic area and also take out suspected sample tissues
- imaging test through Ultrasound waves
Treatment for endometriosis
There’s presently no cure for endometriosis. However, there are treatment options to manage/relief endometrial pain and infertility related to endometriosis
- Pain medication
- Non steroidal anti-inflammatory drugs (NSAID) such as Ibuprofen and Naprofen may help t relief pain associated with endometriosis.
- Hormone Therapy
- Hormonal pills are also very effective in reducing or preventing endometrial pain.
- Hormonal contraceptive pills also help to relief endometrial pain.
- Hormone medication may slow down endometrial tissue growth and prevent new endometrial implants.
- Gonadotropin-releasing hormone agonists and antagonists halt the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This further result in the shrinking of endometrial tissues.
- Surgery (g. Laparoscopy)
- to remove endometrial tissues.
- to burn endometrosis lesion outside the uterus.
- to remove scar tissues that have displaced ovaries and fallopian tubes in the pelvis.
- to relief endometrial pain.
- to help a woman get pregnant.
Note: (i) Not all treatment will work for all women. Your fertility specialist should counsel you on the treatment that suits your need.
(ii) Endometriosis symptoms may return after the treatment is stopped.