What does it mean if you have endometriosis? Endometriosis is a gynecology disorder where the inner lining of the uterus, known as the endometrium grows out of the uterus into other tissues such as the fallopian tubes, ovaries, intestines and other tissues in the body (on rare occasions it can be found in the brain and lungs). Endometriosis is one of the primary reasons for severe painful menstruation.
Endometriosis is estimated to affect about 10.8million women around the world as of about 2015. Endometriosis can begin in young ladies at early as eight years old, but it is most prevalent in women who are in their thirties and above.
Here at Mayor Boss, we don’t want to make you feel frightened about your well-being, but we want to explain to you everything you need to know about endometriosis, so, Let’s get started.
What is the main cause of endometriosis?
The root of endometriosis is not known. however, risk factors that predispose a woman to endometriosis involve:
- History of endometriosis in the family: Your chances of developing endometriosis is 7-10 times higher if someone in your family has it. The closer the person is to you in the gene pool, the higher your chances, for example, your mother, sisters, close cousins, or grandmother. Endometriosis is a disease that can be passed down paternally and maternally
- Early menarche: having your first menstruation before the age of twelve
- Short menstrual cycle: a normal menstrual cycle is 28 days, but it can vary from 21- 35days depending on factors such as stress, change of hormonal birth control, change of habits such as diets, and too much exercise. A menstrual cycle is considered short when your period ends at 21days or less
- Menstrual period lasting longer than 7days. ( the normal length of menstruation is 3-7days within your menstrual cycle)
- Heavy menstrual flow: This can be noted when a woman loss about 80ml of blood and above during each period. That’s about 16teaspoons and above. It can also be determined by the number of pads or tampons used per hour(one or more completely soaked pad or tampon within an hour is considered heavy flow)
- Retrograde Menstrual flow (Flow that moves back into the body): is one of the theories associated with endometriosis. This theory state that when the blood flows backward into the body, it carries endometrial cells from the uterus, which then deposits onto the fallopian tubes and into the pelvic cavity leading to endometriosis
- Surgery: such as Caesarean section(CS) or hysterectomy, is another theory that has been thought to cause endometriosis. The theory suggests a result of misplaced tissues during surgery
- Iron deficiency: is thought to be a trigger for endometriosis
Here are the significant signs and symptoms of endometriosis:
- Recurring stabbing pelvic pain that ranges from mild to severe that occurs days before menstruation and reduce after menstruation. This pain sometimes radiates to the lower back down to the legs
- Mild to severe cramping during bathroom activities(urination and defecation)
- Painful sexual intercourse
- Pain during a pelvic examination
- Hematuria (Bloody urine)
- Chronic fatigue
- Irritable bowel syndrome (constipation and/or diarrhea)
- In rare cases where endometrial tissues are found in the brain, there will be a headache and/or seizures
- If found in the lungs; there will be chest pain, hemoptysis (coughing of blood), pneumothorax (collapsed lungs). This type of endometriosis is called thoracic endometriosis
How do they check for endometriosis?
Diagnosis is made:
- By taking the history of complaints
- Family history
- Pelvic examination
- Laparoscopy: is the only definitive way to diagnosed endometriosis. In this procedure, a laparoscope (camera) will be inserted into the pelvis through a small incision near the navel to look at the reproductive organs and find areas where endometrial tissues are present then tissues will be taken for histological confirmation. The American Society of Reproductive medicine from 1997 has a staging system according to the spread of the endometrial tissue, area of the body affected and the depth affected:
Stage1 (Minimal): Presence of a few superficial implants
Stage 2 (Mild): Presence of more and deeper implants
Stage 3 (Moderate): Many deep implants, small cysts on one or both ovaries. Presence of filmy adhesions
Stage4 (Severe): Many deep implants, large cysts on one or both ovaries. Many dense adhesions
What happens if endometriosis is left untreated?
There may be major complications of endometriosis, which are Infertility and ovarian cysts/adhesions.
How is endometriosis treated?
Treatment aims at managing pain, removing endometrial tissues, and improving fertility as following:
For pain and inhibition of endometrial growth:
- Combined estrogen-progestin birth control pills
- Gonadotropin-releasing hormone (GnRH)
- Progestin-only pill
- Danazol and gestrinone are suppressive steroids that can be used to suppress the growth of endometrial tissue.
- NSAIDs(Ibuprofen and Naproxen)
- Pentoxifylline: is an immuno-modulating drug known to improve pain and improve pregnancy
For removal of tissue to improve fertility and removal of cyst and adhesions
- Laparoscopic surgery is the best form of surgery done for endometriosis because it is minimally invasive, suitable for women who still desire to be mothers, and good for restoration of normal pelvic anatomy. This surgery consists of the excision of the endometrium, adhesions, and resection of the endometrioma ( endometrial cyst).
- Ablation of endometriosis (burning and vaporizing endometrial tissues with an electrical device)
- Hysterectomy(Removal of the uterus): recommended for those who do not wish to give birth or are done with childbearing.
- IVF after laparoscopic surgery is an option for those trying to conceive
Lastly, while you’re here, check out our articles, what you should know about STIs.