Endometriosis

What is endometriosis?

Endometriosis is a disorder where the lining of the uterus (endometrium) migrates through the fallopian tubes to one or both ovaries where it forms cysts on the ovary. This is non-malignant and very painful. The bleeding around the period time into the abdominal cavity produces most of the symptoms of endometriosis.

Who does endometriosis affect?

Endometriosis affects 10 to 15 percent of women between 25- and 45-years old. It has also been reported that 30 to 50 percent of infertile women have endometriosis.

What are the signs and symptoms of endometriosis?

The main symptoms of endometriosis are lower abdominal and pelvic pain, heavy period, irregular periods and infertility. The physician may feel a pelvic mass on pelvic examination. The woman may give a history of painful periods (dysmenorrhea) while in the past she always had pain-free periods. Other signs and symptoms include:
• Painful sex shortly before or around the time of the patient’s period (dyspareunia);
• Lower abdominal pain (in cases of bladder or colon endometriosis);
• Pain during urination and rectal bleeding during menstruation;
• Formation of cysts in ovarian tissue;
• Dark brown blood; and
• Bowel obstruction.

How is endometriosis diagnosed?

During the diagnosis stage and prior to starting treatment, the gynecologist will perform a thorough assessment. Depending on the symptoms this might involve a pelvic ultrasound case study, an X-ray of the bladder and ureters (voiding cystourethrogram), X-rays of the rectum and sigmoid colon (Barium enema), and possibly an MRI or CT scan. There might also be some blood tests and infertility studies.

How is endometriosis treated?

Treatment в will vary depending which stage of four possible stages of endometriosis the patient is experiencing.

In stages 1 and 2 the gynecologist may want to use a medical approach with several different medications such continuous birth control pill, danazol (brand names: Danocrine, Cyclomen) or a short treatment period of gonadotropin-releasing hormone analogue (brand name: Synarel).

If medical treatment fails in stages 1 and 2, or for stages 3 and 4 surgery would be required. Laparoscopic surgery can remove smaller endometriosis lesions, cauterize them, vaporize or excise them by laser surgery.

Abdominal hysterectomy is reserved for patients with severe pelvic pain that has not responded to any of the other measures, and where the women have finished the reproductive phase in their lives (all child wishes have been fulfilled). Usually the ovaries have to be removed along with the uterus (ovariectomy). Following the hysterectomy and ovariectomy hormone replacement therapy is started using estrogen.

There is also an FDA-approved non-drug method available, IceWave patches from Lifewave, which will control pain.

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