Endometriosis
Endometriosis affects up to one in ten women. It is a condition where the endometrial tissue that lines the uterus grows outside of the uterus on the wall of the pelvis, on the ligaments supporting the uterus, on the ovaries and sometimes on the bowel and bladder.
Symptoms:
Symptoms included pain with periods, ovulation or sex, pain passing urine or opening bowels or continuous pelvic or lower back pain. Some women may have difficulty falling pregnant. Some women may have pelvic pain at other times in their cycle, nausea and vomiting and even headaches.
If any of these symptoms are affecting your quality of life, for example preventing you from attending school or work or doing the things you love it may be time to see a gynaecologist to review them
The exact cause is uncertain but there is definatley a genetic component with women with a family having a 7-8 times higher chance of developing the condition.
Diagnosis:
While the gold standard of diagnosis for endometriosis is laparoscopic or keyhole surgery, ultrasound may be useful in the workup
Management:
Initial surgery for diagnosis and treatment of mild disease, moderate or severe disease will require a further planned procedure and recommendation for referral to an endometriosis expert. While surgery is required for diagnosis and treatment can occur at the same time, ongoing treatment plans can involve hormonal manipulation and ongoing management of pain that may have taken on a chronic nature or fertility.
More information can be found at www.endo.org.nz
Like the endometrium inside the uterus, the endometriotic implants swell and react to the monthly hormonal cycle. The cells grow and become thicker under the influence of oestrogen and bleed when there is a drop in hormones that corresponds to menstruation. When endometrial cells bleed there is a release of prostaglandin – an inflammatory compound that irritates pain fibers in the area and increases pain. The body responds by surrounding the affected area with scar tissue and inflammation. The formation of scar tissue (adhesions) may result in damage to other pelvic structures and may cause these to stick together. Endometriosis can be deep and infiltrating, or mild and superficial. Interestingly, the degree of severity of endometriosis does not correspond well with the amount of pain women experience. Some women experience debilitating pain and have only a small amount of endometriosis and some may have no symptoms at all and have severe disease. This is a further clue that merely the presence of endometriosis is not the whole story and that the amount or sensitivity of pain nerves could play a role in how different women experience endometriosis.
Endometriosis at its heart seems to be a disease of inflammation and impaired immunity. While the normal hormonal fluctuations in a woman’s cycle can promote the growth of endometrial implants in women who have developed endometriosis, it is the ongoing inflammation that causes the problems not the hormones themselves.
It is prudent to remember that currently there is no cure for endometriosis and both conventional and complementary therapies can only relieve symptoms. By taking a holistic view, we can do a very good job in making sure that you are living a wonderful life with minimal symptoms.