AtoZ Diseases

In this condition, endometrial tissue occurs outside of its customary location: the lining of the uterine cavity. Called ectopic tissue, it’s generally confined to the pelvic area, but it can appear anywhere in the body. This ectopic endometrial tissue responds to normal stimulation in the same way that the endometrium does. During menstruation, the ectopic tissue bleeds, which causes inflammation of the surrounding tissues. This inflammation causes fibrosis, leading to adhesions that produce pain and infertility.

Active endometriosis usually occurs between ages 30 and 40, especially in women who postpone childbearing; it’s uncommon before age 20. Severe symptoms of endometriosis may develop rapidly or may develop over many years. This disorder usually becomes progressively severe during the menstrual years; after menopause, it tends to subside.
What causes it?

Although there are several theories to explain this disorder, its precise cause remains unknown.
What are the symptoms of endometriosis?

The painful menstruation is one of the main endometriosis symptoms which may produce constant pain in the lower abdomen and in the vagina, posterior pelvis, and back. This pain usually begins from 5 to 7 days before a period reaches its peak and lasts for 2 to 3 days.

Other clinical features depend on the location of the ectopic tissue:

*

ovaries and oviducts: infertility and heavy menstrual flow
*

ovaries or cul-de-sac: deep-thrust dyspareunia (painful intercourse)
*

bladder: suprapubic pain, dysuria, and hematuria
*

recto vaginal septum and colon: painful defecation, rectal bleeding with a menstrual period, and pain in the coccyx or sacrum (base of the spine)
*

small bowel and appendix: nausea and vomiting, which worsen before menses, and abdominal cramps
*

cervix, vagina, and perineum: bleeding from endometrial deposits in these areas during a menstrual period.

How is it diagnosed?

The doctor will perform a pelvic exam to detect endometriosis. He or she may be able to feel multiple tender nodules on the uterosacral ligaments or between the rectum and vagina or detect ovarian enlargement. Laparoscopy must confirm the diagnosis and determine the stage of the disease before treatment begins.
How endometriosis is treated?

Treatment varies according to the stage of the disease and the woman’s age and desire to have children .Conservative therapy for young women who want to have children includes androgens, such as Danocrine, which produce a temporary remission. Progestins and oral contraceptives also relieve symptoms. Gonadotropin-releasing hormone agonists, which work by inducing false menopause, are commonly used to provide a remission of disease. When ovarian masses are present, surgery must be performed to rule out cancer. Conservative surgery is possible, bur the treatment of choice for women who don’t want to bear children or for extensive disease is total removal of the uterus, fallopian tubes, and ovaries.

No Comments yet »