Endometriosis: Diagnosis, Treatment and preventons.

Endometriosis: Diagnosis, Treatment and  prevention

?What is Endometriosis

Endometriosis may be a common condition that affects women during the reproductive years. It occurs when normal tissue from the uterine lining, the endometrium, attaches to organs within the pelvis and begins to grow. This displaced endometrial tissue causes irritation within the pelvis which will cause pain and infertility

During each menstrual period, most of the uterine lining and blood is shed through the cervix and into the vagina. However, a number of this tissue enters the pelvis through the fallopian tubes. Women who develop endometriosis simply could also be unable to clear the pelvis of those cells. It mainly affects women during their reproductive years. It can affect women from every group and ethnicity. Endometriosis isn't an infection and it's not contagious. Endometriosis isn't cancer

Types of endometriosis

There are several sorts of endometriosis

Peritoneal endometriosis: Peritoneal implants that contains glandular and stromal tissue and answer hormonal changes related to the cycle showing cyclic changes similar but not just like the traditional endometrium. These implants heal by fibrosis.4

Ovarian endometriomas: Benign, estrogen-dependent cyst also referred to as “chocolate cyst” that contains thick, old blood that appears as a brown fluid. This results from recurrent chronic bleeding from the endometriotic implants. In long-standing endometriomas, the endometriotic 

tissue is gradually replaced by fibrotic tissue

Deep endometriosis (DE): this type of endometriosis is characterized by proliferative fibromuscular tissue with sparse endometrial grandular and stromal tissue (akin to adenomyosis), with no surface epithelium. DE doesn't show significant changes during the cycle . Growth of endometriotic nodules are usually found within the uterosacral ligaments, the rectovaginal space, the upper third of the posterior vaginal wall, the bowel, and therefore the tract .4,6

Adenomyosis: Uterine endometriosis presents as asymmetrical uterine enlargement

Disseminated endometriosis: Growth of endometriotic tissue in various organs within the bodyincluding at the scar site

Causes of endometriosis

Although the precise explanation for endometriosis isn't certain, possible explanations include

Retrograde menstruation. In retrograde menstruation, menorrhea containing endometrial cells flows back through the fallopian tubes and into the cavity rather than out of the body. These displaced endometrial cells stick with the pelvic walls and surfaces of pelvic organs, where they grow and still thicken and bleed over the course of every cycle 

Transformation of peritoneal cells. In what’s referred to as the “induction theory,” experts propose that hormones or immune factors promote transformation of peritoneal cells cells that line the inner side of your abdomen into endometrial cells

Embryonic cell transformation. Hormones like estrogen may transform embryonic cells within the earliest stages of development into endometrial cell implants during puberty

Surgical scar implantation. After a surgery, like a hysterectomy or C-section, endometrial cells may attach to a incision 

Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body

Immune system disorder. It’s possible that a drag with the system may make the body unable to acknowledge and destroy endometrial tissue that’s growing outside the uterus

Risk Factors for Endometriosis

Early menarche

First-degree relative with endometriosis

Late menopause

Low body mass index

Müllerian anomalies

Nulliparity

Prolonged menstruation (> five days)

Shorter lactation intervals

Shorter menstrual cycles (< 28 days)

White race (compared with black race)

Women who do experience symptoms may have one or more conditions

Painful periods (dysmenorrhoea) which don't answer over-the-counter pain relief. Some women have heavy periods

Pain during or after sexual activity (dyspareunia)

Painful defecation (dyschezia) which will be cyclic or semi-cyclic

Painful micturition (dysuria)

Lower abdominal pain

chronic pelvic pain

Difficulty in getting pregnant or infertility

Pain associated with the bowels and bladder (with or without abnormal bleeding)

Chronic fatigue

Ovulation pain

Irritable bowel syndrome

Cyclical or perimenstrual symptoms (e.g. bowel or bladder associated) with or without abnormal bleeding

Infertility

Complications

Complications include

Infertility, which may affect 50 percent of these with the condition

Increased risk of developing ovarian cancer or endometriosis-associated adenocarcinoma

Ovarian cysts

Inflammation

Scar tissue and adhesion development

Intestinal and bladder complications

Diagnosis

If you've got any symptoms of endometriosis or are having difficulty becoming pregnant, contact your gynecologist. There are several things she will do to work out if you've got endometriosis, including

Pelvic exam

Ultrasound exam

MRI

Laparoscopy

Biopsy

Treatment and medications

Understandably, you would like quick relief from pain and other symptoms of endometriosis. This condition can disrupt your life if it’s left untreated. Endometriosis has no cure, but its symptoms are often managed

Medical and surgical options are available to assist reduce your symptoms and manage any potential complications. Your doctor may first try conservative treatments. they'll then recommend surgery if your condition doesn’t improve

It may be frustrating to urge diagnosis and treatment options early within the disease. due to the fertility issues, pain, and fear that there's no relief, this disease are often difficult to handle mentally. Consider finding a support group or educating yourself more on the condition

MEDICATION

Pain medications

You can try over-the-counter pain medications like ibuprofen (Advil), but these aren’t effective altogether cases

Hormonal therapy

Taking supplemental hormones can sometimes relieve pain and stop its progression. This therapy helps your body to manage the monthly changes in hormones that promote the tissue growth that happens once you have endometriosis

Hormonal contraceptives

Hormonal contraceptives decrease fertility by preventing the monthly growth and buildup of endometrial tissue. contraception pills, patches, and vaginal rings can reduce or maybe eliminate the pain in less-severe endometriosis

The medroxyprogesterone (Depo-Provera) injection is additionally effective in stopping menstruation. It stops the expansion of endometrial implants. It relieves pain and other symptoms. this might not be your first choice, however, due to the danger of decreased bone production, weight gain, and increase within the incidence of depression in some cases

Gonadotropin-releasing hormone (GRNH) agonists and antagonists

Women take what are called gonadotropin-releasing hormone (GnRH) agonists and antagonists to dam the assembly of estrogens that stimulate the ovary. Estrogen is that the hormone that’s mainly liable for the event of female sexual characteristics. This prevents menstruation and creates a man-made menopause. The therapy has side effects like vaginal dryness and hot flashes. Taking small doses of estrogen and progesterone at an equivalent time can help to limit or prevent these symptoms

Danazol

Danazol is another medication wont to stop menstruation and reduce symptoms. While taking danazol, the disease may still progress. Danazol can have side effects including acne and hirsutism, which is abnormal hair growth on your face and body. Other drugs are being studied which will improve symptoms and slow disease progress

Conservative surgery

Conservative surgery is for ladies who want to urge pregnant or experience severe pain and for whom hormonal treatments aren’t working. The goal of conservative surgery is to get rid of or destroy endometrial growths without damaging your reproductive organs

Laparoscopy, a minimally invasive surgery, is employed to both visualize, diagnose, and take away the endometrial tissue. Your surgeon will make small incisions in your abdomen to get rid of the growths surgically or to burn or vaporize them. Lasers are commonly used lately as how destroy this “out of place” tissue

Last-resort surgery (hysterectomy)

Rarely, your doctor may recommend a complete hysterectomy as a final resort if your condition doesn’t improve with other treatments. During a complete hysterectomy, your surgeon will remove your uterus and cervix. Your doctor also will remove your ovaries because they create estrogen, and estrogen causes the expansion of endometrial tissue. they're going to also remove visible implant lesions

This radical approach to treatment is employed only other treatment approaches have failed, and therefore the pain and inflammation are interfering with quality of life. This procedure will stop the cycle of menstruation, and symptoms of endometriosis should reduce. there's no guarantee that each one pain will get away , however

You’ll be unable to urge pregnant after a hysterectomy. Get a second opinion before agreeing to surgery if you’re brooding about starting a family

Prevention of Endometriosis

Endometriosis can't be prevented. this is often partially because the cause is poorly understood. But long-term use of contraception hormones (patch, pills, or ring) may prevent endometriosis from becoming worse