A medical condition in which the tissue that normally lines the uterus, called endometrium, grows in other areas of the body. This can cause irregular bleeding, pain, and sometimes infertility. The tissue can grow on the outside of the uterus, ovaries, and many other areas of the body. Usually the pain is most severe during the days of the month when the endometrium is sloughed off in the woman's cycle, as the tissue which has grown in incorrect areas attempts to do the same thing.

There is some evidence indicating that endometriosis is carried genetically, but it is occuring much more commonly with each generation. Endometriosis is estimated to occur in 10 to 20% of women in their reproductive years, and may be as high as 15 to 40% of infertile women. Adolescents with endometriosis often experience pain, sometimes extreme cramping, but it is usually written off as normal and ignored.

The condition is often treated with drugs that initiate a state of "pseudopregnancy", where the body enters a state resembling pregnancy through hormone treatments, or "pseudo menopausal", where the body enters a state resembling menopause. However, several of the drugs used for this in the past have been found to have side effects making them unusable today. Sometimes, laser burning of the endometrial tissue is done for severe cases. This often solves the problem, but because endometrium can grow in locations outside of the usual scope of laparoscopy, it sometimes isn't enough. Hysterectomy is a final solution.

Endometriosis affects over 5 million women in North America alone, the number of women affected world wide is phenomenal. 

Endometriosis is tissue that grows on the surface of organs located in the pelvic area among other areas in the body.  The tissue is much like the tissue inside of the uterus called the endometrium, this is where endometriosis derives its name from.  It has been called other names such as nodules and lesions.  Common places endometriosis is found in the body are the following:

Symptoms

The most common symptom of endometriosis is pain.  This pain can be very severe at times or it could just be slight pain.  The amount of pain does not directly reflect the amount of endometriosis in the body.  Other symptoms of endometriosis include:

  • infertility
  • overactive menstrual period
  • pain after sex
  • severe cramps
  • lower back pain
  • bleeding between periods
  • pain during bowel movements
  • pain while urinating
  • pelvic pain

Women who suffer with endometriosis may also experience gastrointestinal disorder and severe fatigue.


Endometriosis does not target one specific group of women.  Young girls who get their first menstrual cycle and women going through menopause have the same chance of getting endometriosis.  However, if the woman is going through hormone replacement therapy after menopause her symptoms may continue for a longer period.  It is believed that roughly 10% of women who are at their reproductive age have endometriosis. 

Over 30% of the women with endometriosis experience infertility.  This makes endometriosis one of the top causes of infertility in women.  Many women's endometriosis does not get properly diagnosed until they have trouble trying to get pregnant.  Physicians suggest that these women try to get pregnant for over six months before the physician will start any course of treatment for the endometriosis. 

Causes

Physicians still don't know exactly what causes endometriosis.  However, they have several theories about the causes.

  • Retrograde Menstrual Flow - This theory suggests that the tissues shed when a women is having her menstrual cycle collects in her pelvis.
  • Genetics - Scientists believe endometriosis is either inherited or a result of a genetic disorder.  Researchers have not found a specific gene to prove this theory.
  • Estrogen - Estrogen has been linked to promoting the growth of endometriosis in many women.
  • Research is being conducted to determine if endometriosis can be caused by contact with everyday chemicals.

If the physician suspects that you have endometriosis, they may run tests such as an ultrasound or an MRI, to try and see the endometriosis, but the only sure way to find out if you have it is a surgical procedure called a laparoscopy.  I have had several of these procedures myself.  They are outpatient surgery so they are usually performed in same day surgery, unless there are complications.  It was not very painful since the only incision was right at the bottom of my navel, where my physician inserted the laparoscope to search for the endometriosis.

Sadly, there is no cure for endometriosis.  I have had a complete hysterectomy and had my ovaries removed and my physician told me that the endometriosis or its symptoms may return. 

Treatment

Depending on the level of pain experienced by a women suffering from endometriosis, the physician may prescribe something as mild as an over-the-counter medication or as strong as a narcotic such as Percocet.  I had to be on a stronger dosage of medication due to the fact that I was experiencing severe pain in my lower abdomen.

Your physician may suggest hormone therapy along with the pain medication if your endometriosis is located in a small area.  The hormones are usually given in pill form such as:

Ultimately, your physician may suggest surgery.  This is often the best choice for those suffering from severe endometriosis.

Women who suffer from infertility due to endometriosis may have to get pregnant by in vitro fertilization.  The women may have to have a laparoscopy done to remove the endometriosis before the in vitro fertilization can be done.  This helps increase her chances of becoming pregnant.

Many women who suffer from endometriosis say that the pain went away after menopause. 

My first experience with endometriosis was at the age of 21, when I was attempting to get pregnant.  I would have severe pain during menstrual cycles and after sex.  After exhausting trials of pain medications, my physician finally decided to proceed with a laparoscopy and removed some of the endometriosis and shortly thereafter, I was pregnant.  I didn't experience any more problems from the endometriosis until around the age of 26, when I started having the severe pain with menstrual cycles again. 

After years of pain and more trials of medication and more laparoscopies, my gynecologist finally determined at the age of 30 I needed a hysterectomy.  It was a difficult decision for my gynecologist because I was so young and only had one child.  However, I didn't plan on having any other children and was more than happy to have the hysterectomy, if it would ease my pain.  I am now on hormone replacement therapy, where I take Prometrium and Bellergal at night and use a hormone cream that I rub on my arm once a day.  The cream and Bellergal help the hot flashes and night sweats and the Prometrium keeps my hormones in balance.


Sources:
http://www.obgyn.net/
http://www.gyncancer.com
http://www.endocenter.org
http://www.clinicaltrials.gov
http://www.sensiblehealth.com

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