Endometriosis is accurately defined as the presence of endometrial-type mucosa on the outside of the uterine cavity. Endometriosis is usually a common cause of pelvic pain. This is a disease that is quite difficult to diagnose because the patient normally exhibits several symptoms.
What Is Endometriosis?
It is a medical condition that affects the reproductive system of females and is characterized by primary symptoms such as infertility and pain. The endometrial lesions usually form in the pelvic cavity that encompasses the fallopian tubes, under the ovaries on the tissues which hold the uterus in place, behind the uterus, and on the bladder or bowels. In rare but possible cases, it develops on other body parts or on the lungs.
Researchers are yet to find its real causes and to ultimately find its cure. Nonetheless, researchers strongly suggest that endometriosis results from a combination of several factors such as abnormalities in progesterone and estrogen deficiency in the body’s system which disables the natural destruction of endometrial tissue, genetics, and the womb’s exposure to harmful chemicals in the environment.
Endometriosis is a condition that presents symptoms in the adolescent stage of growth. It is popularly diagnosed via laparoscopy (a surgical procedure). Other methods of diagnosis include X-ray machines and magnetic resonance imaging (popularly known as MRI). MRI is the method that is considered to be more effective, especially in the identification of endometriosis condition of the bladder.
Endometriosis Signs And Symptoms
There are a number of symptoms that are associated with endometriosis. The major signs and symptoms include the ones that have been listed below:
- The patient will experience some pelvic pain.
- The patient may suffer from dyspareunia.
- The patient may experience back pain or lower abdominal pain.
- The patient may suffer from loin pain.
- Pain while exercising is a common symptom.
- Experiencing pain on micturition.
- A patient may also undergo some pain while defecating. This condition is known as Dyschezia.
Risk Factors
The lack of full understanding of this medical condition makes it particularly difficult to find its cure and to pinpoint the risk factors associated with it. However, there are some probable risk factors such as the ones listed below:
i. A patient who has a sister, daughter, or mother with endometriosis condition increases her risk of suffering from it up to six fold.
ii. A patient who has a member of their extended family that is diagnosed with endometriosis condition is at risk of suffering from it.
iii. Women who experience their first menstruation before the age of 11 years are more likely to suffer from the medical condition.
iv. Women who experience short monthly cycles that last for less than twenty seven days are likely to be diagnosed with endometriosis in the future.
v. Women who experience long and heavy monthly cycles that last for periods that exceed seven days are likely to be diagnosed with endometriosis in the future.
Endometriosis Treatments
Symptomatic endometriosis can effectively be managed surgically or medically. Both treatments utilize the rationale of removing the endometrial tissue which has been implanted on the outside of the uterus.
Medical treatments meant for endometriosis operate in several ways so as to eliminate the trophic effect that oestradiol has on both ectopic and eutopic endometrium. It should be noted that medical treatments rarely remove the implants but only act to suppress their action. This is to mean that medical treatments available for the disease only relieve the patient of the symptoms but do not resolve the condition.
The only difference between various medical treatments for endometriosis is the extent of their side effects, some are more adverse compared to others. Below are some common treatments that are used to manage the condition:
i. Non-steroidal anti-inflammatory drugs – These include drugs such as mefenamic acid, diclofenac, and ibuprofen. Their only side effect is gastric irritation.
ii. Progestogens – These include drugs such as norethisterone, dydrogesterone, and medroxyprogesterone acetate. These have side effects like nausea, breast tenderness, fluid retention, and bloating.
iii. Gonadotrophin releasing hormone analogues/combined hormone replacement therapy – Hormone replacement therapy negates the side effects caused by gonadotrophin releasing hormone analogues.
iv. Synthetic androgens – These include drugs such as gestrinone and danazol. They have several side effects associated with them like menopausal symptoms, muscle cramps, weight gain, acne, and seborrhea.
v. Gonadotrophin releasing hormone analogues – These include drugs like triptorelin, buserelin, nafarelin, goserelin and leuprorelin acetate. The main side effect is menopausal symptoms.
vi. Combined Progestogens and oestrogens – It has side effects that are very similar to those that are related with combined oral contraceptives.
Surgical treatment can either be radical or conservative in nature. The conservative type aims at retaining the patient’s reproductive potential. Nonetheless, it can be radical in the sense that it involves the dissection of the bowel, the rectovaginal septum, and the urinary tract.
Whenever surgical treatment is being contemplated, due consideration should be given to the performance of a bilateral salpingo-oophorectomy. Surgery has been associated with very high recurrence rates and is therefore no longer popular among the preferred treatment methods. Pain can also be treated via exercising deep nodules, peritoneal implants, and ovarian cysts.
Factors That Decrease Endometriosis
There are a few factors that serve to effectively decrease the risk of women contracting endometriosis. These are:
- Regular physical exercise that lasts for more than 4 hours per week.
- Regulating body fat to acceptable levels.
The above two factors not only decrease the risk of suffering from endometriosis but also reduce the risk of suffering from several other diseases.
Endometriosis Review Summary
Endometriosis is still a challenging medical condition to date. After diagnosis, it is important that health practitioners establish the underlying problem that needs treatment, such as alleviating the painful symptoms or infertility and consequently focusing on the particular illness and not the disease.
Managing both problems is tricky. Medical treatment should be the first line of defense for painful symptoms of the condition. Surgery should only be the last resort after medical treatments fail. The understanding of this medical condition is evolving and should ultimately translate into some kind of evolution in its clinical management.
