Endometriosis: Symptoms, Causes, Diagnosis & Treatment

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July 18, 2022

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‍What is Endometriosis?

Endometriosis is a painful disorder in which the tissue similar to the tissue that forms the lining of the uterus grows outside the uterine cavity. The disorder occurs when the endometrial tissue lines the pelvis by growing on the ovaries, bowel, and tissues. This endometrial tissue usually does not spread beyond the pelvis, however, it is a possibility. There are three major types of endometriosis:

Superficial peritoneal lesion: This is the commonest kind and is marked by lesions on the peritoneum.
Endometrioma: These are dark, fluid-filled cysts that form deep into the ovaries.
Deeply infiltrating endometriosis: This type develops under the peritoneum and can involve organs near the uterus such as the bladder.

Endometriosis symptoms

The occurrence of endometriosis symptoms and the severity of the symptoms vary from person to person. While pelvic pain is the most common symptom, the severity of the pain does not indicate the degree of the condition. Other symptoms include:

Back pain during the period
Severe menstrual cramps
Heavy menstrual bleeding or bleeding between periods
Discomfort with bowel movements
Diarrhea or constipation
Infertility
Pain following sexual intercourse
Persistent fatigue

Who is at risk?

Endometriosis risk factors include:
Menstrual Issues like shorter cycles, heavier and longer periods, early menarche or late menopause
Never giving birth
a family member having endometriosis
Low BMI

Endometriosis causes

The exact reasons for endometriosis aren’t known. However, some experts think certain theories could serve as endometriosis causes. They are:

Retrograde menstruation: This happens when menstrual blood flows back through the fallopian tubes into the pelvic cavity instead of leaving the body through the vagina.
Mullerian theory: This theory suggests that misplaced cell tissue in the fetal period may go on to respond to the hormones of puberty resulting in endometriosis.
Hormonal activity: This theory suggests that hormones transform the cells outside the uterus into cells similar to the endometrial cells lining the inside of the uterus.
Lymphatic system: This theory suggests that the endometrial cells are transported out of the uterus through the lymphatic system.
Faulty immune system: This theory suggests that endometriosis can happen due to a faulty immune system that isn’t destroying the errant endometrial cells.
Genetics: Genes could also play a role in endometriosis and tends to get worse from one generation to the next.

P.S. None of these theories have been scientifically proven.

How is Endometriosis diagnosed?

Based on the symptoms, a gynecologist may suspect endometriosis. To confirm the endometriosis diagnosis, they can perform one or more of the following endometriosis test:

Pelvic exam: An endometriosis doctor may feel the abdomen for cysts or scars behind the uterus.
Imaging tests: Imaging tests like a transvaginal ultrasound or an abdominal ultrasound, a CT scan or an MRI will help in identifying any cysts associated with endometriosis.
Laparoscopy: Laparoscopy is a minor surgical procedure and the only certain method for identifying endometriosis.
Biopsy: During laparoscopy, the doctor may take a sample of the tissue to study and confirm the diagnosis.

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How is Endometriosis treated?

Endometriosis cure or medicine for endometriosis aren’t discovered yet, but the symptoms can be managed with the following endometriosis treatments:

1. Pain medications

The doctor may recommend pain relievers initially, such as ibuprofen, but these aren’t effective in most cases. Alternative theories like acupuncture, diet changes, and homeopathy work for some women.

2. Hormone

Supplemental hormones can help to relieve the pain in some cases. Hormonal contraceptives like birth control, patches and vaginal rings; gonadotropin-releasing hormone agonists and antagonists; progestin-only contraceptives and Danazol can reduce or even eliminate the pain in less severe endometriosis.

3. Surgery

The doctor might recommend conservative surgery to remove the endometrial growths without damaging the reproductive organs. If the condition does not improve with other treatments or in more serious cases, the doctor may recommend a total hysterectomy as a last resort in which the surgeon removes the uterus or the cervix. The patient will be unable to get pregnant after the hysterectomy.

How can Endometriosis be prevented?

While there are no guidelines on how to prevent endometriosis, one can reduce the chances of developing it by lowering the levels of estrogen in the body. To do so, one can,

Regular exercising and a lower percentage of body fat can help in decreasing the amount of estrogen circulating through the body.
Avoid a large number of caffeinated drinks to avoid raising estrogen levels.
Avoid large amounts of alcohol since alcohol raises estrogen levels.
Talk to your doctor about hormonal birth control methods with lower doses of estrogen.

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