Endometriosis is a condition where tissue that is similar to the inner lining of the uterus grows outside the actual uterus. It acts just like how the inner lining of the uterus does, where it thickens, breaks down, and bleeds during each menstrual cycle. A major distinguishing factor is that it does not exit the body and continues to grow in places where it doesn’t belong. Endometriosis can also cause the surrounding tissue to become irritated, form scar tissue, and cause adhesions (bands of fibrous tissue) to form, allowing pelvic tissues and organs to stick together.
The exact cause of endometriosis is not clear. There are various factors that contribute to the disease developing, though. Probably the most significant is retrograde menstruation, when menstrual blood flows back through the fallopian tubes and into the pelvic cavity (instead of out of the body). This blood can contain endometrial cells from the inner lining of the uterus, sticking to the pelvic walls and surfaces in the pelvic organs, and thickening and growing and bleeding with each menstrual cycle. While there can be many more causes, another possible correlation of endometriosis can be with estrogen, which increases the growth, inflammation, and pain associated. However, the absence of estrogen does not always mean the absence of endometriosis.
Symptoms also vary from patient to patient. Perhaps the most common is severe, life-affecting pain caused by endometriosis, especially pelvic pain. Along with this, more excessive and extreme pain during menstrual cycles, such as worse cramping, is common. Other symptoms include pain during bowel movements and urinating, excessive bleeding, and stomach issues. Significantly, infertility can be caused, as it has been found that nearly half of all with endometriosis have issues with fertility. Some patients may have very little endometriosis tissue but a lot of pain, while others may have a significant amount of tissue but little pain or symptoms, so healthcare providers cannot easily diagnose it.
Risk factors that increase the risk of endometriosis include any health condition that prevents blood from flowing out of the body during periods or health conditions of the reproductive tract. Other factors can be genetic, early-age menopause, heavy or short menstrual cycles, never giving birth, and so forth. Despite this, there are various tests that can be used to check for the disease, like a pelvic exam, a transvaginal ultrasound, an MRI, or a laparoscopy (surgery).
Lastly, treatment can be used at controlling symptoms, but there is no known cure currently or way to prevent endometriosis. The treatment and approach depends on the severity of the condition and the patient themself. Pain medicines and hormone therapy (to ease or get rid of pain, slowing the growth of tissue and to prevent new tissue from forming through lab-made versions of hormones) can be used. Conservative surgery can be used to remove the tissue, fertility treatment, and the last-resort option of a hysterectomy can all be optioned as well.
Amongst all the diseases that plague reproductive-age females, endometriosis is the one which most people have heard about. It affects 10% of this group, 190 million reproductive-age women and girls worldwide. It is important that as many people as possible are educated on endometriosis, because the more people that know about its existence, the more easily they can identify it within themselves and others and get treatment for it as early as possible if present.
References
“Endometriosis - Symptoms and causes” Forbidden: Access is denied., 24 July 2018, www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656. Accessed 28 July 2024.
“Endometriosis” Mayo Clinic, 12 Oct. 2023, www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661. Accessed 28 July 2024.
“Endometriosis” 24 Mar. 2023, www.who.int/news-room/fact-sheets/detail/endometriosis. Accessed 28 July 2024.
endometriosisnews.com/what-is-endometriosis/. Accessed 28 July 2024.
Written by Aarushi Rai from MEDILOQUY