Endometriosis is a disorder where endometrial cells grow where they shouldn’t. While endometriosis is most often associated with the abnormal growth of uterine endometrial cells, it can actually occur everywhere in the human body, except the spleen. However, the pelvic cavity is the most common area for endometriosis.
Other less common sites for endometriosis are the lungs, the diaphragm, and the circulatory system. There have even been rare occasions where endometriosis has occurred on the eyes, liver, brain, and even the nasal cavity.
What Causes Endometriosis?
Nobody is absolutely sure about what causes endometriosis, but researchers have come up with some hypotheses that seem to be on the right track. There seems to be a definite genetic predisposition; meaning, if your mother or grandmother had it, you’re at increased risk for it. There have also been parallels with immune system irregularities as well. Some people have even noted that environmental triggers can influence your chances of developing endometriosis.
These are the most widely proposed hypotheses for what causes endometriosis:
- Retrograde menstruation proposes that during the monthly menstrual cycle, endometrial cells fall into the pelvic cavity through the fallopian tubes, allowing some surviving cells to begin growing again
- Metaplasia indicates that extrauterine cells transform into endometrial cells through hormonal or immunological factors
- Immune dysfunction notes that women with endometriosis have decreased cellular immunity, which triggers an immunological response. This, combined with retrograde menstruation, means that the body doesn’t get rid of the menstrual debris effectively, allowing endometriotic growths
Endometriosis can be found in women of all ages. For example, it has been seen in girls who have just started their menstrual cycle as well as women who are nearing menopause. So essentially, you never know when you might begin to show symptoms of endometriosis.
What are the Symptoms of Endometriosis?
Endometriosis starts when endometrial-like cells start growing outside of the uterus. These cells are very similar to normal endometrial cells, but have some significant differences. One way they are the same, however, is that they respond to the monthly cycle of female hormones. So, endometriosis growths will actually shed, bleed, and grow in tandem, with a woman’s normal menstrual cycle. This shedding causes significant pain and distress, adding to the normal discomfort associated with a period.
As if this isn’t enough, endometriotic growths can also do some tinkering with your genes, allowing them to travel throughout your body. This means that they can grow their own nerve clusters, blood vessels, and hormones. In this way, some doctors think that endometriosis is very similar to cancerous growths.
Because endometriosis grows like this, it’s considered a progressive disease, or able to grow and spread on its own. In some cases, it will even survive a full hysterectomy.
How to Treat Endometriosis?
The most effective method to treat endometriosis is surgery. Surgical removal of the endometriotic growths is done via video laparoscopy. In some instances, surgery is used to perform a complete hysterectomy, with the removal of the ovaries and fallopian tubes being optional.
In cases where surgery is not an option, such as when the symptoms are mild and future fertility may be an issue, NSAID (non-steroidal anti-inflammatory drugs) can be used to help alleviate the cramping and pain associated with endometriosis.
Medications for Endometriosis
For more serious cases, where surgery is still not an option, there are medications that can treat endometriosis. The most common medications used are GnRH agonists (Gonadotropin Releasing Hormone). These hormones suppress the natural estrogen and progesterone production cycle. Patients who take these hormones may experience reduced amounts of inflammation, pain, and bleeding.
This alleviation of symptoms can also assist surgical options, by allowing a surgeon to more accurately assess where the endometriotic masses are and then remove the fibroids with little damage to surrounding tissue.
GnRH agonists are marketed under several names, including Eligard, Lupron, Synarel, Trelstar, Vantas, Viadur, and Zoladex.
Other pharmacological treatments involve the use of low estrogen or progestin-only birth control pills. Combined low estrogen and progestin birth control pills can stop periods completely, which reduces the symptoms and pain of endometriosis, especially in teens.
Progestin-only birth control pills are better for women who have advanced fibroids associated with endometriosis. However, as birth control pills, progestin-only pills are not consistent in preventing ovulation, so there is an increased risk of pregnancy. The demanding regimen in taking these types of pills means they must be taken at the same time every day.
Endometriosis is a very serious condition that can strike women at any age, from the onset of puberty to menopause. As doctors begin to understand more about how and why this malady strikes, more effective means of controlling and preventing it are becoming available. With specialized medications filling the gap between prevention and surgical removal, sufferers of endometriosis have many treatment options to look forward to.
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