Endometriosis is a painful disorder in which tissue similar to the endometrium i.e. tissue responsible for the development of the lining of the uterus grows outside of the female’s uterine cavity. Mostly it involves a person’s ovaries, bowels, fallopian tubes, and tissues lining a person’s pelvis, and is a common gynecological problem. It can also spread beyond pelvic organs, in some cases. The outgrowth tissue is known as endometrial implant and can cause problems like irritation, scar formation, adhesions, severe pain during periods, and fertility problems, etc.

Symptoms

Symptoms of this disorder vary from person to person. Some of the patients experience mild pain, while others experience moderate to severe symptoms. The perception that pain determines the severity of disorder needs to be ruled out. Some of the common symptoms patients experience are:

• Infertility
• Pain during or after sexual intercourse
• Sudden lower back pain during periods
• Painful periods or dysmenorrhea
• Heavy bleeding between periods/ intermenstrual bleeding
• Pain in the lower abdomen in periods
• Cramps one or two weeks around menstruation
• Discomfort with bowel movements
• Fatigue, bloating or nausea during periods

It has also been seen that some patients may experience no symptoms. Pelvic Inflammatory Disease (PID), Irritable Bowel Syndrome (IBS) or ovarian cysts have almost similar symptoms; hence easily mistaken. Getting a gynecological exam performed can help in proper monitoring and diagnosis of the disorder.

Causes

The root cause of the disease hasn’t been found yet, but some of the unproved possible causes as per medical resources include:

• Retrograde menstruation: Generally, in regular periods, the lining of the uterus gets shed into blood, which flows in the form of menstrual blood through a small opening known as the cervix and exits a person’s body through the vagina. But in retrograde menstruation, the menstrual blood which consists of endometrial cells flows back through the fallopian tube into the pelvic cavity, rather than being disposed off the body. These cells accumulate on the pelvic surfaces and walls in each period.
• Immune system disorder: It is hypothesized that the immune system fails to recognize and destroys the tissue growing outside the uterus.
• Peritoneal cell transformation: Due to some hormones and immune factors, a transformation of peritoneal cells i.e. cells lining the inner side of the abdomen, into endometrial cells takes place.
• Surgical scar implementation: The endometrial cells get attached to a surgical incision after surgeries like hysterectomy or C-section.
• Embryonic cell evolution: Hormones like estrogen evolve the embryonic cells into endometrial-like cell implants during puberty.
• Endometrial cell transport: The endometrial cells can be transported to various parts of the body through blood vessels or lymphatic system (tissue fluid system).

Treatment

According to medical resources, this disorder has no cure. The only possible solution is to ease or manage pain. These medications are provided as per the recommendations of the doctor after proper diagnosis. If the conservative methods don’t help, physicians are seen to go for surgeries like laparoscopy or hysterectomy in case of complications, as a last resort.

It has been seen that doctors prescribe pain relievers like NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) like ibuprofen, naproxen for patients with mild pain.

Hormone birth control: For patients with heavy menstrual bleeding, doctors have been seen recommending hormone birth control continuously for three months or more, which will prevent the patient from having periods. These pills include birth control pills, patches, and vaginal rings or progestin-only contraceptives which include pills, shots and an IUD (intrauterine device) to reduce the pain. These methods are only prescribed after consultation with doctors.

Disclaimer: The information in no way constitutes, or should be construed as medical advice. Nor is the above article an endorsement of any research findings discussed in the article an endorsement for any of the source publications.

Sources-

1. https://www.healthline.com/health/endometriosis
2. https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
3. https://www.webmd.com/women/endometriosis/understanding-endometriosis-treatment#1

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