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Endometriosis

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Endometriosis

What is endometriosis?

Endometriosis is a condition in which patches of the endometrium (the lining of the uterus or womb) start growing in other places in the body, outside of the womb.

Wherever it grows, the endometrium reacts to the monthly cycle of hormones as it normally would. It builds up with blood, becoming thicker and thicker and eventually breaks down.

However as it is growing in a place where it shouldn't be, there is nowhere for the blood and tissue to go when it does break down. This results in the blood and tissue building up, which can cause intense pain.

As well as this, the body's immune system can attack the endometrial tissue believing it to be 'foreign tissue'. This can result in scarring and adhesions.

Endometriosis can occur in:

  • The ovaries (endometriosis can cause cysts to appear)
  • The fallopian tubes
  • The area behind the womb and in front of the rectum, known as the Pouch of Douglas
  • The bowel
  • The bladder
  • Anywhere in the abdominal cavity.

While many woman may have endometriosis and not experience any symptoms, for others it can cause intense pain and lead to infertility.

Endometriosis

What are the symptoms of endometriosis?

A woman may experience one or more of the following:

  • Painful periods, or pelvic pains just before your periods start
  • Pain during or after sexual intercourse
  • Irregular or heavy periods, or ‘spotting’ between periods
  • Pain/discomfort when urinating (caused by endometriosis on the bladder)
  • Bleeding from the back passage (rectum) during periods, or pain during bowel motions (caused by endometriosis on the bowel)
  • Trouble getting pregnant.

If you have any of these symptoms, visit your doctor immediately. While endometriosis cannot always be cured, the symptoms usually can be treated.

What causes endometriosis?

Researchers are not certain what causes endometriosis. The main theory is that during your period, some of the menstrual tissue flows backwards into the abdomen via the fallopian tubes in a process called ‘retrograde menstruation’. Here the tissue takes root and begins to grow.

However, it is not known why only some women develop endometriosis, when this retrograde menstruation can occur in many other women without having any effect. It may be that genetic factors make certain women more susceptible.

Endometriosis is most commonly diagnosed in women in their mid-20s to 40s.

Can endometriosis affect my chances of getting pregnant?

Most women who develop this condition only have a mild form and fertility is not affected. However, severe endometriosis can lead to blockage of the fallopian tubes or the development of ovarian cysts, which can cause infertility.

Can endometriosis affect my pregnancy?

No. Once you become pregnant, endometriosis will not damage your pregnancy. In fact your endometriosis will probably improve because of the constant high levels of female hormones that are produced during pregnancy.

How is endometriosis diagnosed?

If you think you may have endometriosis, you should consult your doctor, who may refer you to a gynaecologist for further investigation. The only reliable way to make a formal diagnosis is by conducting a type of examination called a laparoscopy. This procedure involves inserting a small tube into your body through a small incision in your abdomen, in order to view the endometrial tissue and take a sample for testing. Endometriosis may be graded as minimal, mild, moderate or severe.

How is endometriosis treated?

There is no cure as such for endometriosis; however, treatments are available that can ease the symptoms associated with the condition. A third of all cases also resolve without any treatment.

Painkillers, especially non-steroidal anti-inflammatory drugs (NSAIDs) are often used to relieve symptoms. Hormone treatments, which act to stop ovulation and suppress hormonal stimulation, can also be extremely effective in reducing symptoms.

Surgery may be carried out in some cases in order to remove the endometrial tissue and can improve the chances of getting pregnant. Women with severe symptoms who have completed their family or who do not wish to conceive, may opt for a hysterectomy (removal of the womb).

Where can I get more information/support?

The Endometriosis Association of Ireland is a self-help group in Ireland, aiming to give women an opportunity to share information and give support. Contact the Endometriosis Association at Tel: (01) 873 5702, Email: info@endo.ie or Web: www.endo.ie.

 

Reviewed: November 30, 2006

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Last Reviewed: 30th November 2006



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