Endometriosis

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admin | Aug 22, 2011 | 0 comments
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Endometriosis is an abnormal condition where endometrial cells (which is found only inside the uterus) is found anywhere in the body, most commonly on the ovaries, fallopian tubes, cul-de-sac, pouch ofDouglas bowel, rectum, bladder. 5% to 10% of reproductive years women have the chance of developing endometriosis.

What are the risk factors for Endometriosis?

Nulliparous (Never giving birth)
Irregular menstrual cycle (usually shorter than 27 days with bleeding lasting longer then 8 days.)
Abnormal condition that prevents the normal passage of menstrual flow
History of pelvic infection

What causes the endometriosis?

The exact mechanism of endometriosis is still unknown but many scientists believed that due to retrograde menstruation, endometrial cells back up through the fallopian tube into the pelvic cavity instead of out through the vagina. These cells invade to the pelvic organ or pelvic wall, where they grow, rip off and bleed same course of the menstrual cycle.

Another theory believe that it may due coelomic metaplasia, suggests that cells surrounding the ovaries and other cells within the pelvic region are able to change into endometrial cells .

What are the signs and symptoms of endometriosis?

Dysmenorrheal (painful periods): This is the primary symptom of endometriosis.
Excessive bleeding: Patients may experience menorrhagia (heavy bleeding) or Menometrorrhagia (bleeding between periods).
Dyspareunia (Pain during intercourse)
Pain during urination or during defecation (bowel movements)
Infertility
Other symptoms may include fatigue, diarrhea, constipation, nausea especially during menstrual periods.

How is endometriosis diagnosed?

Endometriosis can’t be diagnosed alone with symptoms and physical examination.

Diagnosis relies on:

Ultrasound: Vaginal ultrasound won’t definitely diagnosed endometriosis but useful to diagnosed endometriomas (cysts associated with endometriosis).
Biopsy is the definite diagnostic test for endometriosis; biopsy tissue is accomplished by laparoscopy or during surgery.

What is the complication of endometriosis?

Infertility is the main complication of endometriosis. Approximately 33% to 50% have these complications who have endometriosis. Other complications include Adhesion, rupture cyst, bowel obstruction.

What is the management of endometriosis?

Pain medications include: NSAIDs such as ibuprofen, aspirin to help ease painful menstrual cramps.
Hormone therapy is effective in pain management. Hormone therapies include:
Hormonal contraceptive: Birth control pills are effective for pain management. Pill is taken daily for 3 weeks, followed by a period of 1 week of break period.
Progestins: It relives the symptoms of endometriosis .The usual length of treatment is 3-6 months.
Danazol: It helps to preventing the growth of the endometrium cells.
GnRH (Gonadotropin-releasing hormone) agonist: The usual length of management of GnRH agonist is 3-6 months, however. InGermany5mg of norethisterone per/day is used for 12 months. 3 month course of treatment may relive pain as effectively as a 6 month course. Most women will stop bleeding within 2 months of starting treatment. However, someone will experience 3-5 days of vaginal bleeding or spotting about 10-14 days after beginning treatment.
Conservative surgery to remove endometrial implants may increase your chances of success to become pregnant.
Hysterectomy: In severe cases of endometriosis, total hysterectomy (remove the uterus and cervix) as well as salpingo oophorectomy (remove of both ovaries) is the best treatment. Hysterectomy alone is not effective; post hormone therapy is needed for pain management.

What is the prognosis of endometriosis?

Management can’t cure endometriosis. However, it can partially or completely relive symptoms in many patients for a number of years.

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