Endometriosis: Get Rid of the Pain with Proper Treatment
Endometriosis: Definition and Meaning
Endometriosis occurs when normal endometrial tissue (the lining of the uterus) grows outside the uterus. This misplaced tissue may implant itself and grow anywhere within the abdominal cavity. The lining of the womb which is shed every month in the form of menstrual periods is called endometrium. The abnormal growth of cells (endometrial cells), similar to those that usually form inside the uterus, but in this case form in a location outside the uterus, is known as endometriosis. When similar lining is found around other organs, most commonly ovaries, the condition is called endometriosis.
Endometrial tissue, whether it is inside or outside the uterus, responds to the rise and fall of estrogen and progesterone produced by the ovaries during the reproductive cycle. Under the influence of the hormones, the misplaced tissue swells; and when hormonal levels drop, the tissue may bleed. Unlike the normally situated endometrium, which is shed from the body as menstrual discharge, this blood and tissue has no outlet. It remains to irritate the surrounding tissues.
It is believed that severe endometriosis is more likely to be found in women who have delayed pregnancy and for this reason, the condition is sometimes labeled as "career woman's disease".
- Painful periods.
- It generally presents with pain in the lower abdomen, which can worsen during periods.
- There can be backache and also pain tracking down the legs.
- Pain during intercourse and while moving bowels, especially during periods.
- Changing lifestyle, late marriages, stress, late conception and some unknown environmental factors.
- Starting menstruation at an early age.
- Never having children.
- Frequent menstrual cycles.
- Periods that last seven or more days.
- Problems such as closed hymen, which blocks the flow of menstrual blood during period.
- Planning of pregnancy early can possibly prevent recurrence, because there is a break from cyclical period during pregnancy and lactation.
- Oral contraceptive pills are also known to prevent recurrence.
- Women who have been detected to have endometriosis should have annual ultrasound to detect the presence of any ovarian cyst.
- They should have a blood test in the early part of their menstrual cycle to detect their ovarian reserve, because many women with endometriosis are known to have a diminished ovarian reserve.
- Surgical treatment should be initiated in women with large endometriotic cyst.
Treatment depends on the following factors:
- Severity of symptoms
- Severity of disease
- Whether you want children in the future
Some women who do not ever want children and have mild disease and symptoms may choose to just have regular exams every 6 - 12 months. In that case it becomes possible for the doctor to make sure that the disease is not getting worse. The symptoms may be managed using:
- Exercise and relaxation techniques.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve), acetaminophen (Tylenol), or prescription painkillers to relieve cramping and pain.
Treatment may involve stopping the menstrual cycle and creating a state resembling pregnancy known as pseudopregnancy. Oral contraceptive pills containing estrogen and progesterone are used to prevent recurrence.
- The patient should continuously take the medicines for 6 - 9 months before stopping the medicine for a week to have a period. Side effects include spotting of blood, breast tenderness, nausea, and other hormonal side effects.
- This type of therapy relieves most endometriosis symptoms, but it does not prevent scarring from the disease. It also does not reverse any physical changes that have already occurred.
Another treatment involves taking progesterone pills or injections but side effects may be bothersome and include depression, weight gain, and spotting of blood. Some women may be prescribed medicines that stop the ovaries from producing estrogen. These medicines are called gonadotropin agonist drugs. Potential side effects include menopausal symptoms such as hot flashes, vaginal dryness, mood changes, and early loss of calcium from the bones.
Surgery is an option for women who have severe pains that does not improve with hormone treatment, or who want to become pregnant either now or in the future.
Keyhole Surgery: keyhole surgery is considered as a benchmark. The advantages of keyhole surgery are better visualization of structures due to magnification and faster recovery and resumption of daily activities. Internal healing is much better than open surgery, because there is no direct handling of organs. Keyhole surgeries also have cosmetic values. With laparoscopic surgeries it is also possible to treat large endometriomas (collection around the ovaries) and recto-vaginal endometriosis leading to severe pain.