endometriosis

ENDOMETRIOSIS

Endometriosis is a disorder of the reproductive system in which endometrial tissue is found in areas of the body other than the lining of the uterus. These areas include fallopian tubes, ovaries, bowel, other pelvic structures or organs and the membrane which lines the abdominal cavity. This disorder may cause pelvic pain especially during menses. Pain can be mild to severe. Many women who have endometriosis have no symptoms. The problem can also cause infertility.

Ovaries produce the eggs and hormones that cause the endometrium to prepare for a fertilized egg. Around the fifth day of the menstrual cycle the endometrium begins to thicken. Ovulation occurs when an egg is released around the 14th day of the cycle. If the egg is not fertilized, the uterine lining or endometrium is shed during menstruation. If endometrial tissue is found in other areas of the body, it will follow the same cycle. This tissue will respond to hormones causing it to break down and bleed. This may be painful and scar tissue may grow around the area.

Endometriosis is most common in women in their 30's and 40's. Usually after menopause endometriosis is no longer active. Some women may inherit the tendency to have endometriosis as those with a mother, sister or daughter with endometriosis are 10 times more likely to have the same problem.

Endometriosis is believed to be one cause of:

discomfort and pain during one part of the menstrual cycle
sharp pain deep in the pelvis during intercourse

These problems should be discussed with your doctor. Some women with endometriosis have difficulty getting pregnant, however, infertility from endometriosis can often be treated.

Your doctor will take a complete medical and menstrual history along with performing a pelvic exam to determine endometriosis. Confirmation of the diagnosis with a laparoscopy is usually necessary. Under general anesthesia a slender, light-transmitting telescope is inserted through a small incision in the lower abdomen allowing the doctor to see pelvic organs.

Some types of hormones can be given to slow the growth of endometriosis. Drugs can also be given for pain relief.

Surgery may be performed to remove endometriosis and scarred tissue. Healthy ovaries and tubes and uterus may be left to increase chances for pregnancy later. This will usually relieve symptoms of pain, but they may return. It may also solve infertility problems. Both medical and surgical solutions usually help alleviate symptoms from endometriosis. The disease may return however. If one therapy does not work, another can. Symptoms almost always disappear with menopause or removal of ovaries.

If endometriosis is severe or comes back, the uterus may need to be removed along with the ovaries and tubes. Surgery will usually relieve symptoms and stop production of hormones that cause growth of the endometrium.

Emotional issues often must be dealt with when there is chronic pain or recurring endometriosis. Infertility may also cause emotional problems. Talk with your doctor about this.

A woman with endometriosis who still cannot get pregnant may consider other options such as in vitro fertilization (IVF) to become pregnant.

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