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Gynaecologic Problems: Endometriosis


Endometriosis occurs when endometrium tissue is found outside the uterus, usually in the abdomen on the ovaries , fallopian tubes , and ligaments that support the uterus ; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity. Other sites for these endometrial growths may include the bladder, bowel, vagina , cervix , vulva , and in abdominal surgical scars. Less commonly they are found in the lung, arm, thigh, and other locations.
This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does. This means that each month the tissue builds up, breaks down, and sheds. Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation, and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems. The cause of endometriosis is unknown.

Symptoms and Signs

The most common symptoms of endometriosis are:

  • Pain before and during periods .
  • Pain during intercourse.
  • Infertility .
  • Fatigue.
  • Painful urination during periods.
  • Painful bowel movements during periods.
  • Other Gastrointestinal upsets such as diarrhoea, constipation, nausea.

In addition, many women with endometriosis suffer from allergies (cf. HON Allergy Glossary ), chemical sensitivities and frequent yeast infections (cf. vaginitis ).

Diagnosis and Treatment

Diagnosis is considered uncertain until proven by laparoscopy . A laparoscopy usually shows the location, size, and extent of the growths. This helps the doctor and patient make better treatment choices.
There is no cure for endometriosis, however, a variety of treatment options do exist. The goals of treatment may include: relieving/reducing pain symptoms, shrinking or slowing endometrial growths, preserving or restoring fertility, and preventing/delaying recurrence of the disease. The main treatment options include:

  • Pain Medication. These include over-the-counter pain relievers, as well prostaglandin inhibitors. In some cases, prescription drugs may be required.
  • Hormonal treatment aims to stop ovulation for as long as possible and may include: oral contraceptives, progesterone drugs, a testosterone derivative, and GnRH agonists. Side effects may be a problem for some women.
  • Conservative surgery seeks to remove or destroy the growths, relieve pain, and may allow pregnancy to occur in some cases. Conservative surgery can involve laparoscopy or laparotomy . Hormonal therapy may be prescribed along with conservative surgery.
    Radical surgery, which may be necessary in severe cases, involves hysterectomy, removal of all growths, and removal of ovaries.

For further, more detailed information on this topic, please refer to the reference source for this page.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The Endometriosis Association Online:

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