Endometriosis is often diagnosed as a painful condition in which tissue that usually lines the inside of your uterus, the endometrium, grows outside your uterus. Endometriosis commonly involves ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue spreads beyond pelvic organs. Ectopic locations where endometrial tissues are found are called endometrial implants. Cases of endometriosis have been reported in the liver, brain, lung, and old surgical scars.
Endometrial implants are usually benign, i.e. non-cancerous. With endometriosis, ectopic endometrial tissue continues to act as it normally would. Because this displaced group of cells has no way to exit your body, it becomes entrapped. When endometriosis involves the ovaries, cysts called endometriomas are formed. Surrounding tissue becomes irritated, and eventually develops scar tissue and adhesions. Adhesions are abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. Endometriosis is commonly seen in women of the reproductive age and they may experience problems of infertility.
Do I have Endometriosis?
Whether you have endometriosis or not can be understood by certain signs and symptoms that you experience. Some women have symptoms associated with severe pain, whereas others experience no symptoms at all. About one-third of women with endometriosis discover endometriosis as they fail to conceive, or because endometriosis is found during an operation for another reason. The type of symptoms and their severity depends on the location of the endometrial tissue rather than the number of endometrial cells that are growing within it. About three out of four women with endometriosis, complain about pelvic pain along with painful periods. In the initial stages of the disease, one or two mild symptoms may be felt on the first day or day two of the period.
Later, as the condition prevails, symptoms may get worse for more days of the month, both during and before the menstrual cycle. In women over 25 years of age, endometriosis can make it difficult to get pregnant. This is because the endometrial cells release chemicals that cause inflammation leading to hindrance in the normal process of conceiving and also it affects the development of the embryo in its early stage of implantation in the uterine wall.
In the later stages of endometriosis, the scarring caused by the endometrial cells may interfere with the normal physiological process of ovulation due to damage or blockage of fallopian tubes. The damage prevents the journey of an egg along the fallopian tube or the sperm from reaching the egg, causing problems with fertility.
Top Signs and symptoms that indicate Endometriosis
The signs and symptoms of endometriosis include:
- Severe Pain:
- Pain before or during a menstrual cycle
- Pain during or after intercourse
- Lower abdomen, back or pelvic pain
- Pain during defecation and urination
- Pain during ovulation. This is normally experienced around the 14th day of a menstrual cycle in the thigh or leg.
- Heavy Bleeding:
- Episodes of severe bleeding, with or without clot formation
- Irregular menstrual cycle
- Bleeding longer than five to six days
- Abnormal bleeding cycles.
- Bladder and Bowel Problems:
- Episodes of bleeding from the bladder or bowel
- Change in the pattern of bowel habit
- Increased urination
- Bloating: Increased feeling of abdominal bloating, with or without pain at the time of the period.
- Lethargy and tiredness
- Abrupt mood swings
- Inability to function normally
Causes of Endometriosis
Based on the severity, extent, depth, and location of the endometrial implants, endometriosis is classified broadly into four stages – minimal (I), mild (II), moderate (III), and severe (IV). Most cases of endometriosis can also be classified as mild or moderate depending upon the extent of superficial implants and scarring. Moderate and severe type of endometriosis results in cyst formation and more severe scarring. Infertility is most commonly seen in stage IV endometriosis.
The causes and possible factors of endometriosis include the following:
Family History as a Cause of Endometriosis: Women with a familial history of endometriosis have 70-100% chances of being affected by this condition. Also, in cases of identical twins, it is a possibility that both the child is affected by endometriosis.
Retrograde Menstruation: During menstruation, the blood flows out of the vagina, but a little amount also flows backward along the fallopian tubes into the pelvis. In 90% of cases, the blood, which contains the endometrial cells are absorbed or broken down and cause no symptoms; however, in women suffering from endometriosis, this endometrial tissue starts to grow along the linings of the pelvis.
Metaplasia Causing Endometriosis: The transformation of normal pelvic tissue into endometrial tissue causing endometriosis.
- Conceiving in older age
- Heavy menstrual blood flow during periods lasting more than five to six days
- Menarche before eleven years of age
- Shorter regular cycles
- Changes in the immune cells of the body
- Low body mass index
- Alcohol overuse.
Endometriosis is commonly a disease of the reproductive years, and symptoms usually subside after a woman reaches menopause. For women experiencing symptoms of endometriosis, many treatments and therapies are available to provide relief. For infertility related to endometriosis, treatments are available to help increase a woman’s chances of conception through fertility treatments.
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