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Endometriosis - symptoms and Treatment of EndometriosisEndometriosis is a condition where tissue similar to the tissue found in the lining of the womb (endometrium) occurs in small patches in sites outside the womb. It can sometimes be found in the muscle of the womb when it is termed adenomyosis. Where it is found at other locations in the body, it is termed endometriosis. The most common sites are on the ovaries, fallopian tubes and the ligaments in the pelvis that support the womb. Endometriosis affects around 5 in 100 women and is more common in women with infertility. Symptoms of EndometriosisOften Endometriosis produces no symptoms, but sometimes it can cause problems. These problems happen because each month, when a period occurs, the small patches of endometriosis also bleed. This blood cannot escape from the body and it irritates and inflames the surrounding tissues and causes pain. Chronic irritation of these tissues can lead to scarring and adhesions in the pelvis where tissues stick together. This can sometimes cause problems with fertility due to the tubes being obstructed by adhesions or the ovaries being caught up with adhesi o ns, preventing release of the egg. The main symptoms of endometriosis are pain in the abdomen and pelvis, pain with periods (dysmenorrhea) and pain deep in the pelvis during intercourse. Causes of EndometriosisMany theories have been proposed to explain why endometriosis occurs but doctors don't really know the answer. One view is that endometriosis results when fragmants of the tissue lining the womb escape down the fallopian tube and into the abdomen during a menstrual period. These fragmants then seed onto the tissues in the abdomen and patches of Endometriosis form. Your doctor might suspect you have endometriosis from your symptoms, but diagnosis requires visual identification of the endometriosis tissue, usually via a laparoscopy. As when assessing tubal function, a laparoscope is inserted into the abdomen through a small cut, usually below the navel. The surgeon can then see the womb, fallopian tubes and ovaries as they lie in the pelvis. Patches of endometriosis appear like blue or black spots and sometimes scar tissue and adhesions are seen. Does endometriosis cause infertility?Endometriosis can sometimes cause infertility. If you have severe endometriosis, with damage to the fallopian tubes or where your ovaries are trapped in adhesions preventing release of the egg, this will obviously reduce your fertility. Doctors are uncertain whether mild endometriosis, where the tubes and ovaries remain normal, actually causes infertility. However, it is certainly more common in women with infertility. If mild endometriosis does reduce fertility, the underlying mechanism is not clear. Many possibilities have been suggested including inflammatory changes in the pelvis which might upset egg development, transport and fertilisation. There is no good evidence to suggest that endometriosis will increase the risk of miscarriage. Where your tubes are damaged or where your ovaries are trapped in adhesions preventing release of the egg then surgery can sometimes correct this damage. Alternatively, you can be treated by in vitro fertilisation. Where there is no tubal damage and the ovaries are not trapped through endometriosis, and when there is no sperm problem, you should receive similar treatment to that offered for so called unexplained ' infertility. Is treatment available for pain due to endometriosis? Yes, these symptoms can be treated with medication or by surgery. Medication is used to reduce pain and to stop the growth of the endometriosis tissue. Common approaches are to give high doses of progesterone, which stop the growth of endometriosis. |
Women Medical Diseases Abnormal Uterine Bleeding |
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