Endometriosis is a very common condition affecting women during their reproductive years. It can affect women of every social group and some of the symptoms can be very severe. The associated symptoms of endometriosis can have a severe impact on general physical, mental and social wellbeing of women.
What is endometriosis?
Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic, inflammatory reaction. This tissue is usually found in the pelvis and around the uterus (womb), ovaries and fallopian tubes.Endometriosis usually tend to occur after menarche (time of first period) and menopause. Endometriosis is not an infection and it is not contagious. Although it might mimic cancer, endometriosis is not cancer. The symptoms of endometriosis can be very severe and disabling.
What are the symptoms of endometriosis?
The symptoms of endometriosis can vary from one woman to another; indeed some individuals do not have any symptoms at all. When symptoms occur they include the following:
? painful periods (dysmenorrhoea) which do not respond to over-the-counter.
pain relief. Some women have heavy periods.
? pain during or after sexual intercourse (dyspareunia).
? lower abdominal pain.
? pelvic pain which can be long-term.
? difficulty in getting pregnant or infertility
? pain related to the bowels and bladder (with or without abnormal bleeding).
? long-term fatigue.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis which can complicate the diagnosis.
Why does endometriosis occur?
At this time it is not yet known why endometriosis occurs. A number of theories have been suggested but none has been proved. The most commonly accepted theory is that,during amenstrual period, light ‘backward’ bleeding carries tissue from the uterus to the pelvicarea via the fallopian tubes. This is called ‘retrograde’ menstruation. This theory does not explain the occurrence of endometriosis in distant organs like the lungs and around the umbilicus.
Diagnosis
If you have symptoms suggestive of endometriosis you should see your gynaecologist or some other health care provider. A detailed history and examination is carried out, including a pelvic examination (internal examination). There is no simple test for endometriosis. The only way to make a definite diagnosis is by having an operation to have a look inside the abdomen and pelvis, and taking a biopsy of suspected tissue and sending it off for further testing. Not all patients require this and sometimes the diagnosis can be made from the clinical history, physical examination and various investigations like ultrasound scanning and MRI.
Treatment
Treatment must be individualised, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life.Treatment for endometriosis is usually with medications or surgery. Treatment will also depend on whether the woman hopes to become pregnant.
Your gynaecologist will discuss various treatment options but the patient should be involved in all decisions of managing her symptoms.
Complications of endometriosis
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women who have endometriosis have difficulty getting pregnant. The longer you have endometriosis, the greater your chance of becoming infertile. I therefore advise patients with endometriosis not to delay having children because the condition may worsen with time.
Conclusion
Endometriosis is a common disorder affecting many women in Anguilla and many other countries. The main symptom of endometriosis is pelvic pain/dysmenorrhoea, but other symptoms might also present. There are many ways of treating endometriosis, but surgery is often considered when all other measures have failed. Finding a doctor with whom the affected woman feels comfortable is crucial in managing and treating endometriosis.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
