WHAT IS ENDOMETRIOSIS?

A disorder in which tissue resembling the inner lining of the uterus (endometrium) appears at unusual locations in the lower abdomen. This tissue may be found: on the surface of the ovary; behind the uterus, low in the pelvic cavity such as the appendix; on the intestinal wall; and rarely, at other far away sites like lungs.

AFFECTS

Women between puberty and menopause, but most common between ages 20 and 30.

SIGNS & SYMPTOMS

The following symptoms may begin abruptly or develop over many years:

• Recent onset Dysmenorrhoea (Increased pelvic pain during menstrual periods), especially the last days.
• Pain with sexual intercourse.
• Blood in the urine.
• Back pain.
• Pain with intestinal contractions.
• Blood in the stool (sometimes).

CAUSES

Unknown, but the following theory is most accepted among doctors:

Normally during ovulation, the uterus lining thickens to prepare for implantation of a fertilized egg. If this does not occur, the lining tissue peels away from the uterus and is expelled in the menstrual flow. In some cases, this material builds up and passes backward out of the fallopian tubes into the pelvic cavity.

Here it floats freely and attaches itself to other tissues. The transplanted tissue reacts each month as if it were still in the uterus, thickening and peeling away. New bits of peeled-off tissue create new implants. The growing endometrial tissue between pelvic organs may cause them to adhere together, producing pain and other symptoms.

RISK INCREASES WITH

• Previous operations
• Tests for infertility like tubal insufflation

HOW TO PREVENT

Avoid late marriage and late pregnancies. Pregnancy permanently cures some women with endometriosis.

DIAGNOSTIC MEASURES

• Suggestive symptoms.
• History and physical exam by a doctor.
• Laboratory blood studies.
• Surgical diagnostic procedures, such as
• Pelvic sonography.
• X-rays of the lower intestines (barium enema).

POSSIBLE COMPLICATIONS

• Sterility from tissue implants that constrict the fallopian tubes.
• Disabling, but never life-threatening, pain.

PROBABLE OUTCOME

Without treatment, endometriosis becomes increasingly severe. It subsides after menopause when estrogen production decreases.

Symptoms can be relieved with medication, and it is sometimes curable with surgery.

TREATMENT

GENERAL MEASURES

• If one wants children, plan a pregnancy as soon as possible. Pregnancy often cures the disorder. Delaying pregnancy may cause infertility.
• Use sanitary napkins instead of tampons. Tampons may make backward menstrual flow more likely.
• Use heat to relieve pain. Place a heating pad or hot-water bottle on your abdomen or back, or take hot baths to relax muscles and relieve discomfort.
• Your doctor may recommend surgery to remove implants, or a hysterectomy to remove the uterus, fallopian tubes and ovaries in women who don't want to become pregnant.

SPECIFIC

You may use non-prescription drugs, such as Paracetamol, to relieve minor pain.

WHAT TREATMENT OPTIONS ARE AVAILABLE?

Basically, there are just two methods, and neither works very well.

One treatment uses hormones to alter the signals the endometrium receives, essentially creating a state of false pregnancy. Endometriosis is treated with high doses of birth control pills, which change the body's hormone balance and stop the endometrial tissue from growing. Danazol an artificial hormone, may be used to halt menstruation and ovulation, and stop tissue growth.

If medications do not work, the endometrial tissue may be surgically eliminated using, laparoscopy. In developed countries they use lasers to burn away the excess endometrial growth. In severe cases, a hysterectomy (removal of the uterus and ovaries) may be necessary. But endometriosis is rarely eliminated for good. Symptoms can return even if the ovaries and uterus—are completely excised. For most women, the symptoms of endometriosis disappear following menopause.

ACTIVITY

No restrictions.

DIET

No special diet.

CONTACT YOUR DOCTOR IMMEDIATELY, IF

• You have suggestive symptoms.
• The following occurs during treatment:
• Intolerable pain.
• Unusual or excessive vaginal bleeding.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
• Symptoms recur after treatment.

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