Endometriosis
Endometriosis
Endometriosis
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I
INTRODUCTION
Endometriosis,medicaldisorderin which tissue from the lining of the uterus implants and grows in the pelvic cavity and other parts of the body. The severity of the condition varies widely: In some women, endometriosis causes no symptoms; in others it is painful and debilitating. Experts estimate that endometriosis occurs in approximately 10 to 15 percent of menstruating women between the ages of 25 and 44, most often in women who have never given birth.
II
HOW ENDOMETRIOSIS DEVELOPS
Theuterusconsistsof a firm outer coat of muscle, known as the myometrium, and an inner fleshy lining, known as the endometrium. In a menstruating woman, each month the endometrium thickens in response to the sex hormone estrogen, which is produced by the ovaries. If pregnancy does not occur, the endometrial tissue breaks down and discharges through the vagina, accompanied by bleeding (see Menstruation).
Inendometriosis,endometrial tissue grows in locations outside the uterus, including in or around the ovaries, fallopian tubes, pelvic cavity, and . Occasionally endometrial tissue is found in sites far from the uterus, such as the lungs and upper limbs. Endometrium found outside the uterus behaves the same way that it would inside the uterusit may increase in size and shed with bleeding. This bleeding may cause dense scar tissue to form around the fallopian tubes, ovaries, and other body structures and may eventually interfere with their normal function.
III
SYMPTOMS AND CAUSE
Endometriosiscancause pain in the lower abdomen and pelvic area before, during, and after menstruation, and irregular or heavy bleeding during menstruation. Other common symptoms include pain during sexual intercourse and pain when passing stools or urinating. In extreme cases scar tissue may obstruct the fallopian tubes, preventing the passage of an egg from the ovaries to the uterus and causing infertility. If scar tissue forms on the intestines it may cause obstruction of the bowel, which left untreated can become a life-threatening condition. For reasons unknown, some women with extensive endometriosis do not experience any symptoms while some with minimal disease suffer debilitating discomfort.
Scientistsdonotknow the cause of endometriosis. One theory proposes that endometrial tissue in menstrual blood may travel up through the fallopian tubes and implant in the pelvic cavity. Another theory proposes that the cells lining the abdominal cavity may transform into endometrium. A third theory suggests that endometrium may possess the capacity to invade blood vessels and travel to different parts of the body through the circulatory system, lodging in any organ of the body.
IV
DIAGNOSIS AND TREATMENT
Todiagnoseendometriosis, a doctor performs a pelvic examination and a laparoscopy. In this surgical procedure, a thin, lighted tube is inserted into a small incision in the abdomen to enable the surgeon to view the pelvic organs.
Treatmentofendometriosis may involve either drugs or surgery, and sometimes both. Since endometrial tissue depends on estrogen to grow, physicians prescribe drugs that change the body's estrogen balance and halt endometrium growth. These drugs include high doses of birth control pills and drugs that halt ovulation and menstruation, including danazol and a class of drugs called gonadotropin-releasing hormone analogues. If medications do not work, the endometrium tissue may be surgically removed using laparoscopy. Most commonly the diseased tissue is destroyed by means of lasers attached to the laparoscope. In severe cases, a hysterectomy (removal of the uterus) may be necessary. For most women, the symptoms of endometriosis disappear following menopause.
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