The endometrium is the tissue lining the inside of the uterus, and plays key roles during pregnancy and the menstrual cycle. Endometriosis is a disease characterized by the abnormal and uncontrolled growth of cells, similar to endometrial cells, in other parts of the body apart from the uterus. The disease mostly affects the pelvic region, with the tissue normally growing over the bowels, ovaries, fallopian tubes and tissue lining of the pelvis. However, endometrial tissue may also grow outside of the pelvic, though this is very rare.
Because endometrial tissue is affected by hormonal changes brought about by the menstrual cycle, the exogenous tissue can become inflamed or irritated. The tissue will also go through the regular changes that the endometrium goes through, such as growing, thickening and eventually breaking down. This degraded tissue will then be trapped in these regions and may cause certain complications.
If you believe you may be suffering from endometriosis, we recommend consulting a specialist as soon as possible. If you reside in Lahore, you should look up a Gynecologist in Lahore.
Symptoms
Though most with the disorder do not necessarily experience symptoms, those that do suffer from them with varying severity. The major symptom here shared by most cases is major pain in the pelvic region, which could be linked to changes in the menstrual cycle. Other symptoms include:
- Periods that seem more painful than usual, with the pain potentially beginning some time before the start of the menstrual period, as well as extending many days into it
- Pain following sexual intercourse or during it
- Heavy menstrual bleeding
- Bleeding between menstrual periods, also known as intermenstrual
- Reduced fertility
- If the ovaries are affected, cysts called endometriomas may develop
- Pain during bowel movements or urination (most commonly during menstrual periods)
- Fatigue
- Nausea, potentially with vomiting
- Bloating
- Constipation
- Abdominal or back pain
The last 5 of these symptoms, as with most others, are aggravated by menstrual periods.
Because of the trapped degraded endometrial tissue, scarring will occur, and adhesions may develop due to surrounding tissue being irritated. Adhesions are bands of fibrous tissue that will eventually cause pelvic tissue and organs to bind together.
Understand that the severity of the symptoms is not necessarily representative of the stage or progression of the disease. Someone with a mild form of the disease may experience severe symptoms, while someone that has a form of the disease that has progressed much further may have very mild symptoms and might not even realise that they suffer from it.
Treatment
Though endometriosis has no cure, it can be mitigated, and its symptoms can be managed.
There are medication options, but surgery is also available to reduce symptoms and avoid complications.
Medications include pain medication to deal with pelvic pain; hormone therapy to try and mitigate the progression of the disease as well as reduce symptoms of pain; estrogen blockers, like GnRH agonists and antagonists, to prevent menstruation and aggravation of symptoms; and aromatase inhibitors, which reduce the amount of estrogen in the body.
Surgical options include conservative surgery, which targets only the endometrial tissue that has implanted in other parts of the body, and is not a permanent solution; and hysterectomy, with removal of the ovaries, which is considered a more effective solution to severe symptoms.
All of these options come with great risks and should be considered carefully with the guidance of a professional. If you reside in Karachi, you may be interested in the Best Gynecologist in Karachi.