Endometriosis: Causes, Symptoms, Diagnosis, and Treatment

Endometriosis is a disorder in which tissue similar to the tissue that forms the lining of the uterus grows outside the uterine cavity. The lining of the uterus is also called the endometrium. Check out the symptoms of endometriosis, causes of endometriosis, endometriosis diagnosis and treatment in full below.

Causes of Endometriosis

Until now endometriosis is one disease that has not been known with certainty the cause. There are several theories about the cause, although no theory has been proven scientifically to prove it.

The following are some conditions that can cause endometriosis:

1. Retrograde Menstruation

In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of leaving the body.

Endometrial cells attach to the pelvic wall and the surface of the pelvic organs, where cells grow and continue to thicken and bleed every menstrual cycle.

2. Transformation of Peritoneal Cells

The experts found that hormones or immune factors encourage the transformation of peritoneal cells – cells that line the inside of the stomach – into cells similar to endometrium.

3. Embryonic Cell Transformation

Hormones such as estrogen can convert embryonic cells, cells in the earliest stages of development – into implant cells like endometrium during puberty.

4. Surgical Scar Implantation

After operations such as hysterectomy or cesarean section, endometrial cells can attach to the surgical incision.

5. Endometrial Cell Transport

The system of blood vessels or tissue fluid (lymphatics) can transport endometrial cells to other parts of the body.

6. Immune System Disorder

Problems with the immune system may make the body unable to recognize and destroy tissue such as endometrium that grows outside the uterus.

Symptoms of Endometriosis

Women can experience endometriosis without symptoms or experience various types of pain, including painful menstrual cramps or heavy menstrual periods, pain during or after sexual intercourse, pain during bowel movements or urination, and abdominal pain.

Abnormal located endometrium can grow and decay during the menstrual cycle, causing bleeding between these periods. Inflammation, cysts, scarring, and adhesions can develop which can lead to intestinal problems, chronic pelvic inflammatory disease, or infertility.

The following is an explanation of the symptoms of endometriosis, including:

  • Cramps

Pelvic pain and cramps can begin before or a few days after menstruation. This condition can also make you experience back pain and lower abdomen

  • Pain

Pain during or after sex is a common symptom of someone with endometriosis.

  • Pain when defecating and urinating

You will most likely experience these symptoms during your menstrual period.

  • Excessive bleeding

You may experience occasional heavy menstrual periods or bleeding between menstrual periods (intermenstrual bleeding).

  • Infertility

Sometimes, endometriosis is first diagnosed in those who seek treatment for infertility.

Well, that’s a symptom of endometriosis that can be recognized. Other signs and symptoms may experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

The severity of the pain is not a reliable indicator of the extent of the condition. You can have mild endometriosis with severe pain, or you can have advanced endometriosis with little or no pain.

When is the Right Time to See a Doctor?

See your doctor if you have signs and symptoms that can indicate endometriosis. Early diagnosis can result in better management of symptoms.

Endometriosis diagnosis

Diagnosis can be a challenge because there is no single test for evaluating this disease. The only way to truly confirm this condition is to undergo a surgical laparoscopy.

Surgical laparoscopy is a minimally invasive procedure in which a thin, bright tube with a mini camera is attached, inserted through a small incision in the pelvic area.

Other diagnostic strategies include pelvic examination, radiological imaging with ultrasonography or magnetic resonance imaging (MRI), and the use of certain drugs including gonadotropin releasing hormone (GnRH) agonists.

Stage Endometriosis

Endometriosis has four stages or types, namely:

  • At a minimum.
  • Light.
  • Moderate.
  • Severe.

Various factors determine the stage of the disturbance. These factors can include the location, number, size, and depth of endometrial implants.

Stage I: Minimal

In minimal endometriosis, there are small lesions or wounds and shallow endometrial implants in the ovaries. There may also be inflammation in or around the pelvic cavity.

Stage II: Light

Mild endometriosis involves mild lesions and superficial implants in the ovaries and pelvis.

Stage III: Medium

Endometriosis is involving deep implants in the lining of the ovary and pelvis. In addition, more lesions may appear.

Stage IV: Severe

The most severe stage of endometriosis is deep implants in the pelvic and ovarian layers. There may also be lesions in the fallopian tubes and intestines.

Endometriosis treatment

Endometriosis is actually a disease that cannot be cured with drugs, but you can manage the symptoms.

Manage Endometriosis Symptoms

Complementary and alternative medicine such as acupuncture, chiropractic, and herbal medicine, for some people, has benefits, but this method is not supported by scientific evidence.

Avoiding caffeine can help reduce pain, because caffeine can worsen symptoms. In addition, try for moderate exercise such as walking, this method reduces pain and slows the development of the condition by reducing estrogen levels.

It is important to monitor symptoms, because long-term complications of endometriosis can occur. Unbearable pain or unexpected bleeding should get treatment to the doctor immediately.

Although there is currently no cure for endometriosis, most women can ease the pain of symptoms and can still have children.

Ultimately, medical and surgical options are available to help reduce symptoms and manage potential complications. The doctor may first try conservative treatment, then can recommend surgery if the condition does not improve.

Everyone reacts differently to this treatment option. Your doctor can help you find the most suitable method. Consider finding a support group or educating yourself more about the conditions experienced.

The following are some endometriosis treatments that can be done, including:

1. Pain Reliever

You can try over-the-counter painkillers such as ibuprofen, but endometriosis treatment is not effective in all cases.

2. Hormone Therapy

Taking additional hormones can sometimes relieve pain and stop the development of endometriosis. Hormone therapy helps the body regulate monthly hormonal changes by encouraging tissue growth that occurs when suffering from endometriosis.

3. Hormonal contraception

Hormonal contraception reduces fertility by preventing menstruation and accumulation of endometrial tissue. Birth control pills, patches, and vaginal rings can reduce or even eliminate pain in endometriosis that is not too severe.

Medroxyprogesterone (Depo-Provera) injections are also effective in stopping menstruation. This method stops the growth of endometrial implants and reduces pain and other symptoms.

However, this method may not be the first choice because of the risk of decreased bone production, weight gain, and an increased incidence of depression in some cases.

4. Gonadotropin-releasing Hormone (GnRH) Agonists and Antagonists

GnRH therapy is used to block the production of estrogen which stimulates the ovaries. Estrogen is a hormone that is responsible for the development of female sexual characteristics. Blocking estrogen production prevents menstruation and creates artificial menopause.

This therapy has side effects such as dryness in the vagina and burning sensation. Taking small doses of estrogen and progesterone at the same time can help limit or prevent these symptoms.

5. Danazol

Danazol is another drug used to stop menstruation and reduce symptoms. When using danazol, this disease can continue to develop. Danazol can have side effects, including acne and hirsutism. Hirsutism is abnormal hair growth on the face and body.

6. Conservative Operations

This method is done for women who want to get pregnant, experience severe pain, or hormone treatment does not work. In addition, the aim of conservative surgery is to eliminate or destroy endometrial growth without damaging the reproductive organs.

Laparoscopy, minimally invasive surgery is used to visualize and diagnose endometriosis. This method is also used to remove endometrial tissue.

7. Hysterectomy

Your doctor can recommend total hysterectomy as a last resort if your condition does not improve with other treatments. During a total hysterectomy, a surgeon will remove the uterus and cervix.

This procedure also removes the ovaries because these organs produce estrogen and estrogen which causes growth of endometrial tissue.

Hysterectomy is usually not considered a treatment or cure for endometriosis. If you do this procedure, you will not be able to get pregnant. Don’t be in a hurry to make a decision, more careful consideration is needed before approving this operation if you are thinking of having children.


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