Menstrual cycle is a natural process in women occurring at the interval of every 28 – 30 days. This cycle is controlled by four hormones – Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estrogen, and Progesterone. Every month, a woman’s body goes through hormonal changes. The hormones are naturally released that cause the uterus lining to gradually increase in preparation for fertilization. If pregnancy does not happen, the uterine lining breaks down and bleeding occurs. It is released from the body as a period. For everyone, it’s normal but some women feel pain and a lot of depressing mood swings during this time. Instead of treating it normal, we should try to find the cause so she can feel better and comfortable. Some old people say that every woman goes through this painful cycle but remember, every body is different so the pain level is not the same for every woman.
What is endometriosis?
- Endometrium is the innermost lining of the uterus made up of stratified epithelium. The thickness of this layer regularly undergoes changes during the menstrual cycle. Endometriosis is a medical condition in which tissue like the one lining the uterus (womb) are found elsewhere in the body.
- The endometriosis tissue reacts the same way like how the normal uterine lining tissue does, except that these grow outside the uterus, especially on the ovaries, fallopian tubes, and pelvic tissues.
- During the menstrual cycle, the endometriosis tissue is stimulated by the hormones causing it to grow, break down, and then bleed.
- This internal bleeding of endometriosis that occurs has no way of leaving the body. This results in pain, inflammation, and formation of scar tissue.
- Endometriosis can cause fleshy tissue or blood clots during this period.
Anatomical areas affected by endometriosis
Endometriosis is most commonly found in:
- Fallopian tubes
- Pelvis
- Around the ovaries
- Outside the uterus
- Uterosacral ligaments
- Area between rectum and uterus
It can also be found in other parts of the body such as:
- Eyes
- Lungs
- Brain
- Spine
- Skin
- Appendix
- Rectum
- Intestines
- Bladder
It is important to understand that endometriosis is not an infection or a cancer. It is non-contagious.
Possible causes of endometriosis
There are multiple theories that exist for the cause of endometriosis. Some old beliefs and treatments can worsen this condition if not handled properly on time. However, there is no proven cause for this problem but still, some of the proposed theories and beliefs are given below.
Retrograde menstruation
- It is one of the possible causes of endometriosis.
- The theory indicates that when women have a period, some of the endometrium (uterus lining) flows backwards, mainly through the normally open fallopian tubes.
- This enables the tissue to impact itself on the organs.
Immune dysfunction
According to this theory, the immune system of some women is unable to ward off. However, it is not known whether this causes endometriosis or it is the outcome of endometriosis.
Genes and heredity
According to this theory, endometriosis is passed on to the next generation through the genes of family members. Women with a close female relative having endometriosis are more likely to develop it.
Environmental factors
The theory is that some toxins in the environment (dioxin) can affect the body, the immune system and reproductive system and cause endometriosis.
Symptoms of endometriosis
The most common symptoms of endometriosis are painful or abnormal periods, painful sex, and infertility.
Some of the other symptoms reported in women are:
| Bleeding |
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| Pain |
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| Bladder and bowel |
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| Others |
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Diagnosis of endometriosis
Laparoscopy and biopsy
- The only definitive way to diagnose endometriosis is through laparoscopy.
- It involves making a small incision in the patient’s abdomen.
- A laparoscope (camera) is inserted into the pelvis.
- Through the camera, the doctor is able to see the pelvic organs and identify endometrial tissue.
- The samples of the suspected tissue are removed and sent to the laboratory to confirm if it is endometriosis.
The use of imaging testing such as MRI, CT scan, and ultrasounds are useful but not definitive for diagnosis of endometriosis. Also, lab tests such as blood, urine, and saliva tests do not test for endometriosis.
Treatment of endometriosis
Treating the symptoms and not the cause
There are various ways to provide relief from the symptoms of endometriosis. However, these options do not treat endometriosis itself. These alleviate the symptoms caused due to the condition.
- Hormonal therapy
- Pain management
- Dietary changes
- Acupuncture
- Emotional support
- Low-dose contraceptives
- Hormonal IUDs
- Painkillers, especially NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
Minimally invasive laparoscopic excision surgery is the standard of treatment for deep endometriosis.
The type of treatment chosen for endometriosis is decided by a healthcare professional and the patient. The decision will depend on the follow:
- Age
- Severity of the symptoms
- Severity of the condition
- Risk involved
- Previous treatment
- Priority – pain relief or fertility
For diagnosis or treatment of any type, it is best to speak to your doctor or any healthcare professional. They help you decide on the best treatment option for you and your body. Based on the signs and symptoms, endometriosis is typically treated using medications first. If less invasive treatment options fail, surgery may be recommended.
