Endometriosis is a condition in which tissue similar to the tissue which lines the inside of the uterus (the endometrium), appears outside of the uterine cavity. In endometriosis, endometrial-like tissue typically appears on the outer surfaces of the reproductive organs and structures close by, though they can be found in many other places in the body. The size of the lesions can be microscopic or so large they actually erode adjacent organs. As a result, some women with endometriosis have no symptoms while others are virtually incapacitated from pain. The exact cause of endometriosis remains a mystery, though there are several scientific theories that try to explain this unusual phenomenon.
Endometriosis is typically found in women of child-bearing age, though it has been found in older women less commonly. Some estimate the prevalence of this disease to be between 3-10% of women of child-bearing age, It is the most common gynecologic cause of hospitalization in women in this age group.
Surprisingly, the presence of pain and its severity are not directly related to how extensive the disease is. Some patients with a few small lesions may have significant pain while others with extensive disease have no pain at all. However, pain is thought to be related to the depth to which the lesions penetrate adjacent structures.
Women with moderate to severe endometriosis commonly have pelvic adhesions (scar tissue) which distorts the anatomy of their reproductive organs and can even surround the ovaries themselves, further compromising not only their structure, but their function as well. However, even mild endometriosis can cause infertility, though the reason for this is less clear.
Signs and Symptoms
* Constant pelvic pain or pressure
* Low back pain that occurs prior to the onset of menses and disappears after menses begin.
* Painful menses (dysmenorrhea)
* Painful intercourse (dyspareunia)
* Painful urination or defecation [Please note, however, that by far the most common cause of painful urination in women is a urinary tract infection (UTI), not endometriosis.]
* Premenstrual spotting
* Infertility
* Blood in the urine or stool around the time of the menstrual cycle
Diagnosis
Endometriosis can be suspected based on clinical grounds, but it is clinically confirmed by directly observing implants of endometrial-like tissue by laparoscopy or laparotomy, both of which are surgical procedure.
Prevention
To date, there is no way to prevent endometriosis. If you have a relative with this disease or if you have been diagnosed with endometriosis yourself, many recommend that you not postpone childbearing, since this condition can ultimately result in infertility.
Treatment
Treatment varies, based on the desires of the woman and her symptoms (or lack thereof). They can include simple observation, pain medications, hormonal therapy, or surgery.
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