- Women's Health
Endometriosis - Diagnosing Endometriosis
Endometriosis - diagnosing Endometriosis is often not easy to do, as this is a condition which can go a long time undiagnosed. Far too often it is misdiagnosed as bad period pains and symptoms, or IBS(Irritable Bowel Syndrome)
The endometrium is the tissue that lines the uterus, or womb. During menstruation, this tissue lining is expelled through the vagina.
Sometimes, this tissue, which normally only grows in the uterus, can grow outside on other organs. Most commonly in the reproductive organs (fallopian tubes and ovaries) or in the bladder, rectum or intestines. This is the condition known as endometriosis.
Where the uterus expels the endometrium through menstruation, when it is growing on other organs, the blood it dispels has no way out. The accumulation of this blood causes the growth of cysts, scar tissue and lesions which cause thickening in the surrounding area.
This condition can lead to extreme pain before and during menstruation, leading to a lot of misdiagnosis, as women expect bad pains, and sometimes just think they're the unlucky one who has worse pain than most. Other women can actually have endometriosis without noticing any particular pain.
What Causes Endometriosis?
No one has been able to pinpoint exactly what causes endometriosis, but there are several theories.
One theory is that during menstruation, the endometrium travelled backwards through the fallopian tubes, settling in the abdomen to grow.
Others think that it's normal for menstrual tissue to backup, but where normally the immune system will destroy any tissue appearing where it doesn't belong, if this fails, the endometriosis has the chance to develop.
A third theory is that the endometrium has been in the woman's body, since her own birth and for whatever reason or cause, reappears in adulthood, or suddenly develops in whichever organ it had settled.
Since no one really knows how it's caused, neither do they know how to cure it, although there are ways to ease the symptoms, and to remove it temporarily. More often than not it will recur.
Symptoms to watch out for:
Very painful periods, or pain during ovulation, chronic pelvic pain, difficulty conceiving, extreme pain during intercourse, abnormally heavy menstrual flow, (showing how easily this can be misdiagnosed as bad periods) diarrhoea, constipation, pain with bowel movements etc during menstruation.
The reason these pains are worse during menstruation, is that hormones stimulate the endometrium, even if they're growing outside of the uterus.
The reason for pain during intercourse can be that two different organs i.e. bowel and ovary, have tissue on the outside, and can become stuck together. This can cause all kinds of pains in bladder and bowel, and during sex.
All these symptoms can be evaluated by a doctor, more easily while you are menstruating. An ultrasound scan can be used on the pelvis, but for the internal organs, a laparoscopy is needed.
This is a keyhole surgery using a laparoscope (a light on the end of a very small tube). This is inserted into a small incision close to the navel. During surgery the abdomen is filled with gas to separate the organs, for better viewing.
Any tissue seen here can be removed at this moment, for biopsy. It is also possible for surgery to be done there and then, depending on the severity of the disease.
It is possible that endometriosis can cause infertility; owing to scarring, lesions and damage that it can leave behind. Not by any means does this suggest that you have no chance of conceiving if you suffer with endometriosis.
If you're not trying to conceive, and you don't have a serious case, you probably won't need medical treatment. It is usual to allow nature to take its course, and after the menopause, endometriosis will stop, just the same as menstruation.
Any mild pain can be helped with ibuprofen, paracetamol, etc.
Contraceptive pills, progesterone etc will help as these drugs block ovulation so the endometrium will not bleed, whether in the uterus or not.
Endometriosis can be removed, but not totally cured or prevented. It can be removed by:
Laser laparoscopy, where instead of the light to see, a laser is used to cut or cauterise the unwanted tissue.
Hysterectomy will remove any endometrium or scar tissue left behind, but may not cure the disease unless the ovaries are removed as well, as they will continue to produce oestrogen, thus encouraging the tissues to grow elsewhere.
Endometrium in the bowel can be removed by taking out the affected section of the bowel (bowel resection)
Generally endometriosis is thought to grow mostly in bodies with faulty or weak immune systems. A healthy immune system will normally identify and destroy any tissue growing anywhere that it shouldn't. This is something that is being researched nowadays; trying to establish and understand the workings of the immune system and endometriosis
It is estimated in Britain that 2 million females suffer from endometriosis, and up to 70% of them go undiagnosed. Some have no pain or symptoms, some think they have bad periods or IBS (irritable bowel syndrome)
Doctors who specialise in endometriosis will tell you the majority of women, by the time they get to see them, have had the disease for many years before they were correctly diagnosed, or even suspected enough to be sent to a specialist.
The prevention, the cause, and the cure all still remain a mystery, but at least now more people are becoming aware, and there are ways to ease the symptoms.