ENDOMETRIOSIS

Facts

• N This is a painful disorder where the tissue that normally lines the insides of the uterus grows outside of the uterus.
• N It is often found in the lower abdomen or pelvis, but it can also appear anywhere in the body.
• N The exact cause of endometriosis is not certain but there are several potential explanations such as:
  
  1. Immune system disorder. Due to a woman’s impaired immune system, her body might not be able to destroy endometrial cells that grow outside of the uterus leading to endometriosis.
  2. Retrograde menstruation. This occurs when menstrual blood which contains endometrial cells flow back through the fallopian tubes and into the pelvic cavity instead of outside the body. Displaced endometrial cells stick to pelvic walls and surfaces of pelvic organs where it continues to thicken and bleed over the entire course of the menstrual cycle.
  3. Surgical scar implantation. After surgery such as a C-section or hysterectomy, the endometrial cells may attach to the incision and grow, resulting in endometriosis.
  4. Embryonic cell transformation. There are instances where cells that are in the earliest stages of development, called embryonic cells, are transformed by hormones into endometrial cell implants during puberty.
  5. Endometrial cell transport. Blood vessels or the lymphatic system may transport endometrial cells to other parts of the body and implant there.
• N Endometriosis is associated with pain because when a woman affected by it has her period, she not only bleed from the tissues inside the uterus but also from the ones outside. When blood touches other organs, especially inside the abdomen, it can cause irritation and inflammation which results in pain. It may also result in a scar tissue which can be the root case of pain.

Who are at risk

• N Age. Endometriosis typically develops in women between ages 24-40.
• N Alcohol use. Consuming alcoholic beverages can raise estrogen levels and it could place you at a higher risk for endometriosis.
• N Early menarche. This means women who menstruate for the first time before the age of 11 have a higher risk.
• N Family history of endometriosis. Having a mother or sister with endometriosis increases your risk. Endometriosis can be passed down both maternally or paternally.
• N Shape of reproductive organs. It is highly likely to occur if either your uterus, cervix,  or vagina is abnormally shaped which ends up blocking or slowing down the menstrual flow.

Signs and Symptoms

The symptoms associated with endometriosis are often cyclical, which mean that the pain is worse right before or during the period.

• N Painful periods
• N Lower abdominal pain
• N Bowel and bladder symptoms (pain with bowel movements, bloating, constipation, painful urination, blood in urine)
• N Premenstrual spotting
• N Pain with intercourse
• N Infertility

Some women may not have any symptoms of endometriosis. For others, the symptoms may come and go, or it could get worse over time.

Diagnosis

• N Pelvic exam. A pelvic exam is done by palpation. The doctor manually feels areas in your pelvis for any abnormalities, such as cysts on the reproductive organs or scars behind the uterus. While it is not always possible to feel small areas of endometriosis, there are instances where it may cause a palpable cyst or nodule to form.
• N Ultrasound. A procedure that uses sound waves to make an image of internal organs to look for a specific type of ‘chocolate’ cyst that is common with endometriosis.
• N MRI (Magnetic Resonance Imaging). This is helpful in determining the extent of deep infiltrating endometriosis, especially in cases where laparoscopic inspection is obscured by adhesions.
• N Laparoscopy. A surgical procedure where the doctor looks in the abdomen using a camera through a small incision. A sample is then taken from a suspected endometriosis lesion for biopsy. It is considered to provide a definitive diagnosis of endometriosis.

Treatment

• N Hormone Treatments – This is a conservative treatment that is advised to be tried first before moving to more invasive surgical options. This may include progestin-only medications, contraceptives, or birth control patches to help regulate the growth of uterine tissue and provide relief from the symptoms of endometriosis.
• N Medications – The pain that comes with endometriosis can be treated with over-the-counter medications, but these aren’t effective in all cases.
• N Operative Laparoscopy – This is a surgical procedure to remove endometrial growth and adhesions. The surgeon may either excise the tissue or use intense heat (ablation) to destroy areas of endometriosis. In the same surgical setting, scar tissue and endometriotic cysts can be removed.
• N Hysterectomy – This is a surgical procedure to remove the uterus, especially in cases where endometriosis is extensive. This treatment is considered as the last resort since it is highly invasive, and it can eliminate a woman’s ability to conceive.

Endometriosis can be effectively diagnosed and treated to minimise the symptoms. Don’t just assume that painful periods or intercourse is normal. Talk to Dr. Pamela Tan today of you experience any of the symptoms mentioned above.

Don’t wait any longer if symptoms persist. Book a consultation, here, or call our clinic directly at 6254 2878.