Endometriosis is a disorder in which tissue similar to the tissue that forms the lining of your uterus grows outside of your uterine cavity. The lining of your uterus is called the endometrium. It occurs when endometrial tissue grows on your ovaries, bowel, and tissues lining your pelvis. It’s unusual for endometrial tissue to spread beyond your pelvic region, but it’s not impossible. Endometrial tissue growing outside of your uterus is known as an endometrial implant. The hormonal changes of your menstrual cycle affect the misplaced endometrial tissue, causing the area to become inflamed and painful. This means the tissue will grow, thicken, and break down. Over time, the tissue that has broken down has nowhere to go and becomes trapped in your pelvis.
This tissue trapped in your pelvis can cause: irritation, scar formation, adhesions, in which tissue binds your pelvic organs together, severe pain during your periods and fertility problems.
Endometriosis is a common gynecological condition, affecting up to 10 percent of women. You’re not alone if you have this disorder.
SYMPTOMS: Symptoms of endometriosis vary. Some women experience mild symptoms, but others can have moderate to severe symptoms. The severity of your pain doesn’t indicate the degree or stage of the condition. You may have a mild form of the disease yet experience agonizing pain. It’s also possible to have a severe form and have very little discomfort. Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms: painful periods, pain in the lower abdomen before and during menstruation, cramps one or two weeks around menstruation, heavy menstrual bleeding or bleeding between periods, infertility, pain following sexual intercourse, discomfort with bowel movements and lower back pain that may occur at any time during your menstrual cycle. You may also have no symptoms.
It’s important that you get regular gynecological exams, which will allow your gynecologist to monitor any changes. This is particularly important if you have two or more symptoms.
TREATMENT: Understandably, you want quick relief from pain and other symptoms of endometriosis. This condition can disrupt your life if it’s left untreated. Endometriosis has no cure, but its symptoms can be managed.
Medical and surgical options are available to help reduce your symptoms and manage any potential complications. Your doctor may first try conservative treatments. They may then recommend surgery if your condition doesn’t improve. Everyone reacts differently to these treatment options. Your doctor will help you find the one that works best for you. It may be frustrating to get diagnosis and treatment options early in the disease. Because of the fertility issues, pain, and fear that there is no relief, this disease can be difficult to handle mentally. Consider finding a support group or educating yourself more on the condition. Four Treatment options include:
1. Pain medications: You can try over-the-counter pain medications such as ibuprofen, but these aren’t effective in all cases.
2. Hormone therapy: Taking supplemental hormones can sometimes relieve pain and stop the progression of endometriosis. Hormone therapy helps your body regulate the monthly hormonal changes that promote the tissue growth that occurs when you have endometriosis.
3. Hormonal contraceptives: Hormonal contraceptives decrease fertility by preventing the monthly growth and buildup of endometrial tissue. Birth control pills, patches, and vaginal rings can reduce or even eliminate the pain in less severe endometriosis. The medroxyprogesterone (Depo-Provera) injection is also effective in stopping menstruation. It stops the growth of endometrial implants. It relieves pain and other symptoms. This may not be your first choice, however, because of the risk of decreased bone production, weight gain, and an increased incidence of depression in some cases.
4. Gonadotropin-releasing hormone (GnRH) agonists and antagonists: Women take what are called gonadotropin-releasing hormone (GnRH) agonists and antagonists to block the production of estrogen which stimulate the ovaries. Estrogen is the hormone that’s mainly responsible for the development of female sexual characteristics. Blocking the production of estrogen prevents menstruation and creates an artificial menopause. GnRH therapy has side effects like vaginal dryness and hot flashes. Taking small doses of estrogen and progesterone at the same time can help to limit or prevent these symptoms.
5. Danazol: Danazol is another medication used to stop menstruation and reduce symptoms. While taking danazol, the disease may continue to progress. Danazol can have side effects, including acne and hirsutism. Hirsutism is abnormal hair growth on your face and body.
Other drugs are being studied that may improve symptoms and slow disease progress.
6. Conservative surgery: Conservative surgery is for women who want to get pregnant or experience severe pain and for whom hormonal treatments aren’t working. The goal of conservative surgery is to remove or destroy endometrial growths without damaging the reproductive organs. Laparoscopy, a minimally invasive surgery, is used to both visualize and diagnose, endometriosis. It is also used to remove the endometrial tissue. A surgeon makes small incisions in the abdomen to surgically remove the growths or to burn or vaporize them. Lasers are commonly used these days as a way to destroy this “out of place” tissue.
7. Last-resort surgery (hysterectomy): Rarely, your doctor may recommend a total hysterectomy as a last resort if your condition doesn’t improve with other treatments. During a total hysterectomy, a surgeon removes the uterus and cervix. They also remove the ovaries because these organs make estrogen, and estrogen causes the growth of endometrial tissue. Additionally, the surgeon removes visible implant lesions. A hysterectomy is not usually considered a treatment or cure for endometriosis. You’ll be unable to get pregnant after a hysterectomy. Get a second opinion before agreeing to surgery if you’re thinking about starting a family.
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