Fembryo Fertility & Gynaecology Clinic
Endometriosis
Endometriosis is a condition in which cells similar to the lining of the uterus, or endometrium, grow outside the uterus.
Endometriosis Treatment and Support
Endometriosis is typically a painful condition in which tissue that resembles the endometrium, which normally lines the lining of your uterus, grows outside of your uterus.
The tissue lining your pelvic area, fallopian tubes, and ovaries are all frequently affected by endometriosis. Rarely, tissue that resembles endometrium may be discovered elsewhere. Menstruation pain is not the only side effect of endometriosis; it can also lead to infertility and uncomfortable sexual activity.
With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down, and bleeds with each menstrual cycle. This tissue becomes trapped and often, but not always, results in pain. When endometriosis involves the ovaries, cysts called endometriomas may form – this is the only time it can be diagnosed by ultrasound.
Usually, a laparoscopy is necessary to diagnose, stage, and remove endometriosis.
Signs and Symptoms
Common signs and symptoms of endometriosis include:
- Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain. Pelvic pain is however not always cyclical.
- Pain with intercourse.
- Pain with bowel movements or urination. You’re more likely to experience these symptoms during a menstrual period.
- Excessive bleeding. You may experience occasional heavy menstrual periods or bleeding between periods (intermenstrual bleeding).
- Infertility. Sometimes, endometriosis is first diagnosed in those seeking treatment for infertility or after failed fertility treatments.
- Other signs and symptoms. You may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.
Your level of pain might not be a good indicator of how bad your condition is. Endometriosis could be mild and cause a lot of pain, or it could be severe and cause little or no pain.
Endometriosis is sometimes misdiagnosed as pelvic inflammatory disease (PID) or ovarian cysts, which can also cause pain in the pelvis. It might be confused with irritable bowel syndrome (IBS), a condition that causes diarrhea, constipation, and stomach cramps. Endometriosis and IBS can occur together, which can complicate the diagnosis.
Endometriosis Diagnosis
When to see a doctor
See your doctor if you have signs and symptoms that might point to endometriosis.
Endometriosis can be difficult to deal with. With an early diagnosis, a multidisciplinary medical team, and an understanding of your diagnosis, your symptoms may be better managed.
Treatment Options for Endometriosis
While there is no cure for endometriosis, there are several treatment options available to manage the symptoms and improve quality of life.
Endoscopic Surgery
Endoscopic surgery is beneficial for patients with endometriosis because it is a minimally invasive procedure, meaning it involves smaller incisions and less tissue damage than traditional surgery. This can result in less pain and scarring, a shorter hospital stay, and a quicker recovery time.
During endoscopic surgery for endometriosis, the surgeon can remove areas of endometrial tissue, cysts, and adhesions that may be causing pain and other symptoms. This can significantly reduce the symptoms of endometriosis and improve the patient’s quality of life.
In addition to treating endometriosis, endoscopic surgery can also be used to diagnose the condition by taking tissue samples for biopsy. This can help ensure an accurate diagnosis and guide treatment options.
Medication
One of the most common treatments for endometriosis is medication. Hormonal therapies can help alleviate pain and reduce the growth of endometrial tissue. Pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) are also commonly used to manage pain and cramping.
For women with infertility caused by endometriosis, assisted reproductive technologies such as in-vitro fertilization (IVF) can be used to increase the chances of pregnancy.
Individual Treatment Plans
At Fembryo Clinic, the treatment options for endometriosis are tailored to the individual needs of each patient and may involve a combination of medication, surgery, and lifestyle changes such as diet and exercise. We feel that it is important to work closely with our endometriosis patients to develop a treatment plan that is best suited to their needs.
Endometriosis Causes
Even though no one knows for sure what causes endometriosis, these things could be to blame:
Retrograde menstruation.
In retrograde menstruation, blood with endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These endometrial cells stick to the walls of the pelvis and the surfaces of the organs in the pelvis, where they can grow, get thicker, and bleed during each menstrual cycle.
Surgical scar implantation.
Endometrial cells can stick to a surgical incision after a hysterectomy or C-section.
Endometrial cell transport.
Endometrial cells may be moved to other parts of the body by the lymphatic system or the blood vessels.
Changes in the cells in the peritoneum.
Experts think that hormones or immune factors cause peritoneal cells, which line the inside of your abdomen, to change into endometrial-like cells. This is called the “induction theory.”
Embryonic cell transformation.
During puberty, hormones like estrogen may change embryonic cells, which are cells in their earliest stages of development, into cell implants that look like endometrium.
Immune system disorder.
If the immune system isn’t working right, the body might not be able to recognise and kill endometrial-like tissue that is growing outside of the uterus.
Risk factors
You may be at a higher risk of developing endometriosis if you:
- Have never given birth
- When you get your period at a young age
- Experiencing menopause when you’re older
- Short Menstrual cycles for example: lasts less than 27 days
- Periods that are heavy and last longer than seven days
- Have elevated levels of estrogen in your body. Being exposed to more estrogen over the course of your life can cause cancer.
- The body mass index is either low or high.
- One or more family members (mother, aunt, or sister) have endometriosis.
- Any medical condition that stops blood from leaving the body during menstruation.
- Disorders of the reproductive system
Endometriosis Complications
Infertility
The main complication of endometriosis is that it makes it hard to have children. Women with endometriosis have trouble getting pregnant about one-third to one-half of the time.
Doctors sometimes advise that women with endometriosis shouldn’t delay having children because the condition may get worse over time.
Fertilisation and implantation: Endometriosis can cause infertility by preventing the egg from being fertilised, moving through the Fallopian tube, and implanting in the uterus.
Cancer Risk
People with endometriosis do get ovarian cancer more often than would be expected. But the chance of getting ovarian cancer in general is low, to begin with. Some studies show that this risk is higher if you have endometriosis, but it’s still relatively low. Endometriosis-associated adenocarcinoma is a type of cancer that can happen later in life to people who have had endometriosis. It is rare, but it can happen.
Most of the time, a diagnosis can’t be made from an examination or an ultrasound alone. To diagnose and determine the stage of cancer, and to remove it, laparoscopic surgery is required.
Endometriosis Management
After surgical removal, hormone therapy is used to keep the endometriosis under control.