Endometriosis - Causes, Symptoms, Diagnosis and Prevention

Managing Endometriosis

Dr.Purnima Nadkarni profile Authored by Dr.Purnima Nadkarni on 11 Mar 2014 - 18:19.

Endometriosis is a complex disease affecting women during the reproductive years, wherein the uterus gets affected. This relatively unknown disease claims victims in overwhelming numbers affecting about 89 million young women in the reproductive age group worldwide. It is one of the main reasons for stomach pain and inability to conceive in women between 25 to 30 years of age. Endometriosis can cause severe pain before or during periods, and heavy or abnormal bleeding. It is a condition, where the tissue that normally lines the uterus grows somewhere else, like on the ovaries, behind the uterus or on bowels or bladder.Up to 10 percent of all women have endometriosis.

 

Based on the location, extent and depth of the endometriosis implant, the stages of Endometriosis are:

I-minimal

II-mild

III-moderate

IV-severe

What exactly causes endometriosis is still unknown although there are several theories. One of the common theories, called “The retrograde menstruation theory” suggests that some menstrual blood and endometrium flows backwards from the uterus through the fallopian tubes and into the pelvis during a menstrual period. This tissue then grows where it lands in the pelvis. 

Many times, it may have absolutely no symptoms at all. Commonly presented symptoms may vary, based on the location of tissue growth, symptoms may include:

  • Abdominal cramps or back pain during menstruation
  • Painful bowel movements
  • Painful urination during menstruation
  • Heavy bleeding
  • Painful intercourse
  • Infertility
  • Diarrhoea
  • Constipation
  • Nausea during menstruation
  • Ovarian cysts containing endometriosis

Since some patients with endometriosis might not show any symptoms at all, the doctor will need surgery to prove endometriosis. Endometriosis is considered mild, moderate, or severe depending on what is found during surgery. Women with mild disease can have severe symptoms, and women with severe disease can have mild symptoms.
 

Pelvic Exam– To detect the following findings:

  • A tender nodule or the  retroverted uterus
  • Enlarged or fixed ovaries
  • Visible endometriosis implants
     

Laparoscopy- To see the pelvic organs and look for endometriosis, with the help of a thin camera that is inserted into the abdomen through a small incision near the navel. Laparoscopy evaluates the extent of endometriosis:

  • Score of 1-15 = Minimal or mild endometriosis
  • Score of 16 or higher = Moderate or severe disease


Other Diagnostic Procedures

In special cases, the doctor may use special imaging techniques like,

  • Ultrasound
  • Computerized tomography (CT ) scan
  • Magnetic resonance imaging (MRI)

These procedures can identify cysts and help characterize the fluid within an ovarian cyst. These tests are useful for women experiencing infertility and/or chronic pelvic pain.

 

There are treatment options for endometriosis that can improve your quality of life via following means:

  • Reducing your pain using medications
  • Shrinking or slowing the endometrial growth
  • Preserving orrestoring fertility
  • Preventing or delaying recurrence of the disease
     

The choice is made based on side effects and cost since several effective treatments are available. For large ovarian endometriomas, hormonal treatments are not effective and surgery is recommended. Surgery also may be indicated when medical treatment is unsuccessful or when medical conditions prohibit the use of hormone treatments.
 

Lifestyle changes

With a few lifestyle changes, you can ease the symptoms of endometriosis:

  • Changes in your exercise and relaxation routines
  • Maintaining a balanced diet.
     

Cyclic or continuous combined hormonal contraceptive therapy includes:

  • Reducing the pain caused by endometriosis by suppressing menstruation and inhibiting the growth of endometriosis.
     
  • Taking combined hormonal contraception without the usual seven-day break eachmonth will prevent you from menstruating, and may be a useful option for womenwho experience their worst endometriosis symptoms during their period.

Progestin therapy

This can be administered in a pill form or as an injection. Progestin therapy helps tolessen the effects of the estrogen that stimulates endometriotic growth in your body.

 

 

Suppression of ovarian function: a GnRH agonist

If combined hormonal contraceptives aren’t effective in treating your endometriosis, you may be prescribed a drug known as a GnRH agonist, which prevents ovaries from functioning.
 

Intrauterine system (IUS)

If combined hormonal contraception or progestin therapy isn’t effective in treating symptoms, the health-care professional may recommend trying anintrauterine system (IUS).  This is a common method of birth control, consisting of a T-shaped device which is inserted into your uterus and releases a type of progestin which counteracts the effects of estrogen in the same way that otherprogestin therapies do.
 

Surgery

If other treatments are not effective in managing your pain or improving your quality of life, laparoscopy can be performed to remove endometrial growths or legions and scarring.


Alternative therapies

Some women find that alternative therapies, such as physiotherapy, massage and acupuncture are effective ways of managing pain.

 

Endometriosis cannot be prevented as the cause is unknown. But prolonged use of birth control hormones may help you to prevent progression and further complications of endometriosis

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.