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What is Endometriosis?
This is an often painful disorder of the female reproductive system. With this condition, a specialized type of tissue that normally lines the inside of your uterus (the endometrium) becomes implanted outside your uterus, most commonly on your fallopian tubes, ovaries or the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond your pelvic region. During your menstrual cycle, hormones signal the lining of your uterus to thicken to prepare for possible pregnancy. If a pregnancy doesn't occur, hormone levels decrease, causing the thickened lining of your uterus to shed. This produces bleeding that exits your body through the vagina — your monthly period. When endometrial tissue is located elsewhere in your body, it continues to act in its normal way: It thickens, breaks down and bleeds each month as your hormone levels rise and fall. Because there's nowhere for the blood from this displaced tissue to exit your body, it becomes trapped, and surrounding tissue can become irritated. Trapped blood may lead to the growth of cysts. Cysts, in turn, may form scar tissue and adhesions — abnormal tissue that binds organs together. This process can cause pain in the area of misplaced tissue, often the pelvis, especially during your period. Scars and adhesions related to endometriosis also can cause fertility problems. Signs & Symptoms of Endometriosis The classic symptom of endometriosis is acquired dysmenorrhea, which may produce constant pain in the lower abdomen as well as the vagina, posterior pelvis, and back. The pain usually begins 5 to 7 days before menses, reaches its peak on days of bleeding, and lasts for 2 to 3 days. It differs from primary dysmenorrheal pain, which is more cramp like and concentrated in the abdominal midline. The severity of pain doesn't necessarily indicate the extent of the disease. Some of the symptoms of endometriosis are: - Painful menstrual cramps with periods that gets worse over time Emotional Symptoms Endometriosis affects women emotionally as well. It’s important to get help from psychologists or counselors to help women cope with their feelings. Some common ones are: - Confusion
Types of Endometriosis Endometriosis is where the lining of the uterus grows outside of the uterus in other areas. Other words for these areas can be called lesions, growths, implants, or nodules. Such ectopic tissue is generally confined to the pelvic area, most commonly around the ovaries, uterovesical peritoneum, uterosacral ligaments, and cul-de-sac, but it can appear anywhere in the body. This ectopic endometrial tissue responds to normal stimulation in the same way the endometrium does. During menstruation, the ectopic tissue bleeds, which causes the surrounding tissues to become inflamed. This inflammation causes fibrosis, leading to adhesions that produce pain and cause infertility. A diagnosis of endometriosis denotes the presence of endometrial tissue outside the lining of the uterine cavity. Other clinical features depend on the location of the ectopic tissue: - ovaries and oviducts: infertility and profuse menses - ovaries or cul-de-sac: deep-thrust dyspareunia - bladder: suprapubic pain, dysuria, hematuria - rectovaginal septum and colon: painful defecation, rectal bleeding with menses, pain in the coccyx or sacrum . small bowel and appendix: nausea and vomiting, which worsen before menses, and abdominal cramps - cervix, vagina, and perineum: bleeding from endometrial deposits in these areas during menses.
What Causes Endometriosis? This condition isn't the only cause of pelvic pain. If you're experiencing pelvic pain, see your doctor to determine whether endometriosis or another condition is the cause, and to target appropriate treatment. The mechanisms by which endometriosis causes symptoms, including infertility, are unknown. The main theories to explain this disorder are: - transtubal regurgitation of endometrial cells and implantation at ectopic sites. - coelomic metaplasia (repeated inflammation may induce metaplasia of mesothelial cells to the endometrial epithelium). - lymphatic or hematogenous spread to account for extraperitoneal disease.
- Blockage Every day, Blood and tissue is shed into the body. Over time, this can cause inflammation and pain. As this tissue grows, it can cover the ovaries and fallopian tubes. This can also hurt the chances of getting pregnant. - Faulty Immune System Some scientists believe that many women with endometriosis have certain immunologic defects or dysfunctions. What scientists don’t know is whether this faulty immune system is a cause or effect of the condition. - Metaplasia Metaplasia happens when one normal type of tissue changes into another normal type of tissue. Some researchers believe that endometrial tissue has the ability in some cases to replace other types of tissues outside the uterus. - Retrograde Menstruation There is a theory that states that menstrual tissue flows backwards through the fallopian tubes. This is called “retrograde flow.” While the tissue is flowing, it leaves deposits on the pelvic organs where it seeds and grows.
This is currently not a working theory, because researchers have found that 90% of women have retrograde flow, but since most don’t develop endometriosis. - Genetics Some studies show that first-degree relatives of women with this disease are more likely to suffer from the problem as well. - Lymphatic Distribution Some researchers believe that fragments from endometriosis travel through the blood or the lymphatic system to other parts of the body. This could explain how the condition manifests in other body parts. - Environmental There is currently a controversial study that states that
environmental factors can contribute to endometriosis.
This same study says that toxins especially have an effect
on the reproductive hormones and immune system.
Risk Factors:
Women have a higher risk of developing endometriosis if
they: - Began getting their period at an early age Active endometriosis usually occurs between ages 30 and 40, especially in women who postpone childbearing; it's uncommon before age 20. Severe symptoms of the condition may have an abrupt onset or develop over many years. This disorder usually becomes progressively severe during the menstrual years; after menopause, it tends to subside. - Cancer Risk There is a mild risk of ovarian cancer for women with endometriosis. One theory for this is that the endometriosis nodules themselves transform into cancer. Another theory states that endometriosis can be related to other genetic or environmental factors, and can cause ovarian cancer.
- The primary complication of the condition is infertility. Prevention:
There are a few studies show that you may lower your chances getting endometriosis if you: - Avoid caffeine and alcohol - Exercise regularly
When to seek Medical Advice: Palpation during a pelvic examination may detect multiple tender nodules on the uterosacral ligaments or in the rectovaginal septum in one-third of patients. These nodules enlarge and become more tender during menses. Palpation may also uncover ovarian enlargement in the presence of endometrial cysts on the ovaries or thickened, nodular adnexa (as in pelvic inflammatory disease). Laparoscopy is used to confirm the diagnosis and determine the stage of the disease before treatment is initiated. How Endometriosis is Diagnosed There are several tests that doctors can run to see if you have endometriosis. A few of them are: - Ultrasound
Tests These are the tests your doctor may perform in order to diagnose this condition: - A biopsy (by laparoscopy)
Treatment/Therapy: The stage of the disease and the patient's age and desire to have children are treatment considerations for endometriosis. In stages I and II (mild forms with superficial endometria and filmy adhesions), conservative therapy for young women who want to have children includes androgens such as danazol, which produce a temporary remission. Progestins and oral contraceptives also relieve symptoms. Gonadotropin-releasing hormone agonists, by inducing a pseudomenopause and, thus, a "medical oophorectomy," have shown a remission of disease and are commonly used. When ovarian masses are present (stages III and IV), surgery must rule out cancer. Conservative surgery is possible, but the treatment of choice for women who don't want to bear children and for those with extensive disease (stages III and IV) is a total abdominal hysterectomy with bilateral salpin¬go-oophorectomy.
Birth Control Pills Birth control pills can make endometriosis less painful.
They prevent the monthly build-up, and breakdown any
growths that you may get.
Progestins Progestins work a lot like birth control pills. They made this
treatment specifically for women who can't take estrogen.
They can also make periods lighter and shorter. GnRH Agonists Gonadotropin Releasing Hormone Agonists (GnRH Agonists)
slow down the growth of endometriosis, thus relieving the
symptoms. They work by reducing the amount of estrogen
in your body, which stops your monthly cycle. Danazol Danazol is a weak male hormone. It’s not used very much
these days, however. Danazol works much like GnRH
Agonists, but it often causes side effects like weight gain,
oily skin, smaller breasts, tiredness, and hot flashes.
Mirena Mirena is a Progestin Intrauterine Device (IUD). It works by
preventing ovulation. If fertilization does occur, it alters
the lining of the uterus to prevent implantation. Aromatase Inhibitors Aromatase inhibitors are a newer treatment for women with endometriosis. Studies have shown that aromatase inhibitors are effective, however, a total of only 65 patients were included in these studies. Needless to say that research and treatment of endometriosis with
aromatase inhibitors is still in its early days. Pain Medication Here are some of the over-the-counter medications that can treat the pain of this condition
- Ibuprofen Hormone Treatment Doctors often recommend hormone medication to treat
endometriosis. These medications help most for women
who have small growths and not bad have bad pain. Keep in
mind that women on hormone medications can’t become
pregnant.
SURGERY This next set of tips will go over
some of the surgeries available to
diagnose and treat endometriosis. - Laparoscopy Laparoscopy is a surgery where doctors remove growths and scar tissue that causes the pain in endometriosis. A tiny cut
is made in your abdomen, and a thin tube with a light is
placed inside. The doctors can then see the growths, make
a diagnosis. - Laparatomy Laparotomy requires a much bigger cut in the abdomen than with laparoscopy. The doctor then can reach inside
and remove growths of endometriosis in the pelvis or
abdomen. Recovery can take up to two months. - Hysterectomy Hysterectomy is a permanent surgery and should only be done on women who don’t want to get pregnant. This surgery involves the doctor removing the uterus. She might
take out the ovaries and fallopian tubes as well. - Presacral Neurectomy During a presacral neurectomy, the doctor cuts nerve fibers connected to the uterus. This surgery is very effective,
however it can cause long-term side effects, such as
constipation and urinary urgency.
Alternative Therapy Some women look to alternative therapies to help with their endometriosis. Here are some of these therapies: ** Nutritional Therapy Targeted Herbal solutions: Tang Kuei. Tang Kuei is an herb used widely throughout Asia to assist with hormonal problems and anecdotal evidence. Alternate pronunciation is “dong Quai” and in the west it is known as Angelica or Angelica Sinensis. In many cultures it is used from the age of puberty till after menopause. Many ladies swear by Tang Kuei for relief from period pain, from menopause problems and for assisting with Endometriosis.
- 30-40% of women with endometriosis have difficulties getting pregnant. If you’re worried about this, discuss it with your doctor, and you can develop a treatment plan.
- Research shows that using tampons most likely has no
effect on increasing the risk of endometriosis. Douching
after the menstrual period also most likely has no effect on
risks either.
- Support Groups Endometriosis comes with a variety of emotions. It’s a good idea to find a support group, so that you can talk to other women who have endometriosis. There are live support groups, and also Internet communities that you can join.
- Minor gynecologic procedures are contraindicated immediately before and during menstruation. - Advise adolescents to use sanitary napkins instead of tampons; this can help prevent retrograde flow in girls with a narrow vagina or small introitus. - Because infertility is a possible complication, advise the patient who wants children not to postpone childbearing - It is recommended for all women that they have an annual pelvic examination and Papanicolaou test.
Diet change strategies: Nutritional Therapy Woman with endometriosis may want to consider nutritional therapy to help with their symptoms. Having a healthier diet can increase your ability to tolerate medical treatments and their side effects, increase your energy, and help you to think more clearly. Nutritionists are great at assisting you put together a plan that will help.
Vitamin & Nutrient Associations Even when we try to eat well, we're disadvantaged. The nutritional content of most food has been compromised over the years, not only by deficient soils and modern production, transportation, storage and processing methods, but also by the enormous amounts of chemical and artificial substances added to promote growth, storage life, taste and appearance. It's for this reason that more and more medical authorities are advocating the use of vitamin and mineral supplements. However, finding them in the right combination can be both confusing and costly. This allows the cells to grow, repair and to perform their functions with the best possible efficiency so that we feel and look better and are more able to prevent and fight disease. Once the body begins to clear itself of toxins it can more efficiently absorb nutrition. As Aloe Vera Juice is a refreshing and anti-bacterial drink, you might find that taking this daily, diluted in some filtered water will not only refresh you like ‘a shower inside you’ but also assists in dealing with any digestive issues you may also be experiencing. You may find benefit from our information on detoxification as well as a bit about detoxing because of change of diet
We wish you well in your search for solutions to this Endometriosis problem and your movement towards better health in all areas. More Resources available about Endometriosis:
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