by Kimberly Allen R.N.
Endometriosis is a medical condition that affects women’s health during their reproductive years. Endometriosis occurs when cells from the lining of the uterus grow outside the in the body. This happens during a woman’s reporductive years though there have been rare cases of children and post menopausal women being diagnosed with endometriosis.
Approximately 20-50% of women with fertility problems have endometriosis. Endometriosis is usually diagnosed in women between 25-35 years of age though it has been diagnosed in girls a young as 11 years of age. White women are more likely to develop endometriosis than African American or Asian women. There are also studies that indicate endometriosis is more common in women that have a tall thin structure with a low body weight index. Other studies show that women who wait to become pregnant at an older age tend to develop endometriosis more than those that don’t.
The exact cause of endometriosis is not known, however there are a couple of theories. The most common is that endometrial cells escape out the fallopian tubes when there is a back flow during menstration. this theory is further supported as the most common sites for endometriosis growth is on outside of the ovaries and along the outside wall of the fallopian tubes. The other theory is that the tissue lining the organs of the pelvis have primitive cells that are able to alter themselves and grow into other types of cells including endometriosis cells. This theory is supported by the number of cases of endometriosis that occur in other areas of the pelvis though they are fewer. I remember when I was a student nurse on my surgical rotation an one of the first surgeries I observed wa a procedure called exploratory surgery, this was before scopes. The woman had been complaining of abdominal pain for a long time ad none of the standard tests at that time could detect anything. During the exploratory surgery the Dr makes a large incision down the abdomen then starts looking around inside for the problem. The Drs had been searching for a reason for this womans pain for a long time and were talking about closing when one of them said to wait a minute and then he showed us what he’d found. A piece of endometriosis was growing on the side of her small intestine.
Most women that have endometriosis are unaware of it and have no symptoms. However, for those women that do experience symptoms the most common symptom is pelvic pain which usually is most severe just before and during menstruation. However, the location and severity of the endometriosis tissue, called implants. Some endometriosis implants can produce toxins that cirrculate through the bloodstream causing pain. Endometriosis implants can also form scars causing pain. Infertility can also be a symptom of endometriosis especially if there is no other known cause for the infertility.
The goal of treatment for endometriosis is to relieve the pain and/or improve fertility. The two most common treatments for endometriosis are medications and/or surgery. Most Drs will try non-surgical treatments leaving surgery as a last option. Some women are able to get sufficient pain relief using over the counter medications like ibuprofen, others require other treatments like hormone therapy. There are currently several different types of hormone therapy available. However, these treatments do not cure endometriosis they only control the symptoms so if discontinued the pain will return. For women suffering from infertility conservative surgery to remove the endometriosis implants may be the only option to improving your chances of getting pregnant. Today surgery to remove endometiosis implants is done via laprosopic surgery instead of the Dr making a large incision down your abdomen making recovery much faster with less chances for complications. In very severe cases of endometriosis where fertility is not an issue the Dr may recommend a total hysterectomy which is the removal of the uterus and cervix and frequently both ovaries are also removed.
Endometriosis that is undiagnosed and/or untreated can be very frustrating. Living with pain that you are unable to control can lead to depression and increase your chances of developing other health issues. It’s important to talk to your Dr if you feel you may have endometriosis so that together you can develop a plan of care that is effective in treating your symptoms.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.