subject: Endometriosis in Women [print this page] Endometriosis in Women Endometriosis in Women
Endometriosis is a condition where tissue similar to that of the uterine lining migrates to other places in the body. The endometrial tissue may attach to the ovaries, fallopian tubes, outside of uterus, intestines or other structures within the pelvic cavity. On rare occasions, physicians find endometrial tissue outside the pelvic cavity in the brain or lungs and other internal structures.
Your Regular Menstrual Cycle
You must understand what occurs during a normal menstrual cycle and how the hormones associated with it affect the uterus before trying to understand the possible causes of endometriosis. The layer of cells lining the inside of the uterus, known as endometrium, is shed during menstruation. The ovulation cycle and the hormone levels that regulate it affect the thickness of the endometrial layer in the uterus. The endometrial layer is thinnest directly after a menstrual period. The lining thickens during the first two weeks afterward. This cycle prepares the uterine environment for the attachment of a fertilized egg. If the egg remains unfertilized, the uterus sheds its lining during menstruation.
The Course of Endometriosis
Endometriosis results in chronic pelvic pain, heavy and irregular bleeding, and may cause infertility. The fluctuating hormone levels that occur during the menstrual cycle affect the course of endometriosis just as they affect the normal menstrual cycle. For this reason, females do not develop endometriosis prior to menarch (the first menstrual period) or after menopause. The relatively constant levels of hormones during pregnancy and other times where a menstrual cycle is not present decrease the severity of the pain and other symptoms associated with the condition.
Causes
Retrograde Menstruation
Researchers and physicians do not know precisely what causes the development of endometriosis. One theory supposes a sort of backward menstrual flow called retrograde menstruation. With retrograde menstruation, some products of normal menstrual flow, including endometrial cells, may spill out into the pelvic cavity via the Fallopian tubes. These cells then become attached to, or implanted on, various pelvic structures. These cells, although outside their normal uterine environment, naturally respond to the hormones estrogen and progesterone excreted during the menstrual cycle, causing the debilitating and destructive symptoms of endometriosis. Naming retrograde menstruation as the sole cause of endometriosis is problematic since many women with the condition never develop the condition. This suggests other associated factors.
Coelomic Metaplasia
Coelomic (see-LOW-mick) Metaplasia occurs when cells in the pelvic cavity transform into endometrial-like cells with the same characteristics as the normal endometrial tissue. Researchers theorize that infection or retrograde menstruation may trigger this change.
Immune Abnormalities
Others theorize that immune system abnormalities in some women may cause the condition due to a number of studies showing immune anomalies in women with endometriosis.
Surgical Procedures
Since gynecologists have discovered endometrial implants in the scar tissue of pelvic surgical procedures, some theorize that the procedures inadvertently transferred viable endometrial cells to the incision area.
Know When to See Your OB/GYN
Many women do not have any specific symptoms that point to endometriosis. Regular visits to yourOB/GYNare critical because he or she will know your health and treatment histories, which will make her better able to diagnose any health concerns. The most common symptoms are pelvic pain and painful intercourse. The condition often causes infertility, but obstetricians do not have a clear idea regarding how the disease causes the infertility. Even though women often present with no specific symptoms, agynecologist may find tender pelvic nodules or ovarian masses closes associated with endometriosis.
Treatments
The most successful treatment for endometriosis consists of pain management therapies, since women suffering from the condition most commonly complain of chronic pelvic pain. This treatment includes the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen sodium. If these medications fail to control pain, the physician may prescribe narcotic (opioid) medications. OB/GYN Doctors prescribe these under close supervision and care because patients can become physically addicted to them. The next step in treatment protocol attempts to slow or prevent the progression of endometriosis with certain hormones. Surgical removal of the endometrial implant is used as a last resort.
