Endometroisis - Symptoms & Treatment
Endometriosis is can be developed by finding endometrial tissue outside the uterus and commonly affected female of the reproductive age the endometrial cells respond to estrogen and progesterone with proliferation and secretion. During menstruation, the ectopic tissue bleeds, which causes inflammation of the surrounding tissues. Pelvic pain and serious health diseases can be felt by the patients.
Symptoms of Endometroisis
There are basically symptoms are characterized by pain during menstrual periods, excessive bleeding, and infertility. The description includes:
- dysmenorrhea, abnormal uterine bleeding, and infertility (classic symptoms)
- pain that begins 5 to 7 days before menses and peaks and lasts for 2 to 3 days (varies among patients), all hough severity of pain isn't indicative of extent of disease.
- Discomfort menstrual cramps
- Vomiting and nausea
- Burning or stinging sensation during urination.
- infertility and profuse menses (ovaries and oviducts)
- deep-thrust dyspareunia (ovaries or rul-de-sac)
- suprapubic pain, dysuria, and hematuria (bladder)
- lower back pain
- abdominal cramps, pain on defecation, constipation; bloody stools due to bleeding of ectopic endometrium in the rectosigmoid musculature (large bowel and appendix)
Causes of Endometroisis
Retrograde-menstruation theory is the cause of developing endometriosis. The cause of endometriosis remains unknown. The main theories that attempt to explain this disorder include:
- retrograde menstruation with implantation at ectopic sites (although retrograde menstruation alone may not be sufficient for endometriosis to occur because it occurs in women with no clinical evidence of endometriosis)
- genetic predisposition and depressed immune system (may predispose one to endometriosis)
- coelomic metaplasia (repeated inflammation inducing metaplasia of mesothelial cells to the endometrial epithelium)
- lymphatic or hematogenous spread extraperitoneal disease).
Treatment of Endometroisis
The types of treatment depend on the signs and symptoms of endometriosis. Pharmacologic and surgical treatment of endometriosis may be beneficial for managing chronic pelvic pain. Conservative therapy for young women who want to have children includes:
- androgens such as danazol
- progestins and continuous combined hormonal contraceptives (pseudopregnancy regimen) to relieve symptoms by causing a regression of endometrial tissue
- GnRH agonists to induce pseudomenopause (medical oophorectomy), causing remission of the disease (commonly used).
- laparoscopic removal of endometrial implants with conventional or laser techniques
- presacral neurectomy for central pelvic pain; effective in about 50% or less of appropriate candidates
- laparoscopic uterosacral nerve ablation (LUNA) also for central pelvic pain, although definitive studies supporting the efficacy of LUNA are lacking
- total abdominal hysterectomy with or without bilateral salpingooophorectomy.
- Because infertility is a possible complication, advise the patient who wants children not to postpone childbearing.
- Recommend an annual pelvic examination and Papanicolaou test to all patients.