ENDOMETRIOSIS – V.C.

Gynecology essay
>Endometriosis is a disorder in which the tissue that forms the lining of the uterus-the
endometrium- grows outside of the uterine cavity. Endometrium can grow on the ovaries (cysts
called endometriomas may form), bowel, and tissues lining the pelvis; all this extrauterine
endometrial tissue is called endometrial implant. The hormonal changes of the menstrual cycle
affect the misplaced endometrial tissue causing the area to become inflamed and painful, eventually
developing scar tissue and adhesions. 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 the pelvis,
which can cause: irritation, scar formation, adhesions, severe pain during the periods, fertility
problems.

>Endometriosis is a common gynecological condition affecting up to 10 percent of women, mainly

girls and women of childbearing age, usually between the ages of 25 and 40. It's less common in
women who have been through the menopause.

>Endometriosis has four stages determined by factors such as the location, the number, the size and
depth of endometrial implants: minimal (small lesions or wounds and shallow endometrial implants
on the ovary; there may also be inflammation in or around the pelvic cavity); mild (it involves light
lesions and shallow implants on an ovary and the pelvic lining); moderate (it involves deep implants
on the ovary and pelvic lining; there can also be more lesions) and severe (deep implants on the
pelvic lining and ovaries.; there may also be lesions on fallopian tubes and bowels).

>The primary symptom of endometriosis is pelvic pain, often associated with the menstrual period,
far worse than usual, with tendency to increase over time. Common signs and symptoms of
endometriosis may include: painful periods-dysmenorrhea (pelvic pain and cramping may begin
before the period and extend several days into the period. Lower back and abdominal pain may be
present); pain with intercourse (pain during or after sex is common with endometriosis); pain
with bowel movements or urination (especially during the period); excessive bleeding (like
occasional heavy periods-menorrhagia- or bleeding between periods-menometrorrhagia-);
infertility (endometriosis is first diagnosed in some women who are seeking treatment for
infertility); other symptoms such as fatigue, diarrhea, constipation, bloating or nausea, especially
during menstrual periods. The severity of the pain isn't necessarily a reliable indicator of the extent
of the condition.

>Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as
pelvic inflammatory disease (PID), ovarian cysts and irritable bowel syndrome (IBS), a condition
that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany
endometriosis, which can complicate the diagnosis.

>Although the exact cause of endometriosis is not certain, possible explanations include:
retrograde menstruation, transformation of peritoneal cells into endometrial cells, embryonic
cell transformation during puberty by hormones such as estrogen, surgical scar implantation
(after an hysterectomy or a C-section, endometrial cells may attach to a surgical incision,
endometrial cells transport by blood or lymphatic system, immune system disorder making
possibly the body unable to recognize and destroy endometrial tissue that's growing outside the
uterus.

>Risk factors: never giving birth, starting the period at an early age, going through menopause at an
older age, short menstrual cycles (for instance, less than 27 days), having higher levels of estrogen,
low body mass index, alcohol consumption, one or more relatives (mother, aunt or sister) with
endometriosis, any medical condition that prevents the normal passage of menstrual flow out of the
body, uterine abnormalities.

>Complications: infertility -approximately one-third to one-half of women with endometriosis

have difficulty getting pregnant as endometriosis may obstruct the tube and keep the egg and sperm
from uniting, or it may damage the sperm or egg. Ovarian cancer

>Endometriosis has no cure, but its symptoms can be managed. Pain medications such as
ibuprofen (Advil), hormonal therapy (can sometimes relieve pain and stop its progression),
hormonal contraceptives (prevent 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 and medroxyprogesterone (Depo-Provera) injection is also effective in stopping
menstruation. Gonadotropin-releasing hormone (GRNH) agonists and antagonists to
block the production of estrogens that stimulate the ovary; this prevents menstruation and creates an
artificial menopause. The 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.
Danazol is another medication used to stop menstruation and reduce symptoms even if the disease
may continue to progress. Conservative surgery by laparoscopy is for women who want to
get pregnant or experience severe pain and for whom hormonal treatments aren’t working. Last-
resort surgery (hysterectomy) with the removal of the ovaries also because they make
estrogen, and estrogen causes the growth of endometrial tissue but there is no guarantee that all pain
will go away, however.

https://www.nhs.uk/conditions/endometriosis/

https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

https://www.ncbi.nlm.nih.gov/pubmed/11029846

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3730176/

https://ki.se/en/collaboration/endometriosis-a-painful-disease

https://www.healthline.com/health/endometriosis#outlook