Endometriosis is a condition that appears as small implants and cysts in the ovary. However, it may also present with localized nodules. It happens when endometrial tissue grows outside the uterus. This could be in areas such as the ovaries, uterine ligaments, bladder, or intestines. So, it’s incredibly important to recognize endometriosis symptoms early in order to seek treatment.
It is considered one of the main causes of infertility in women. In fact, over 40% of people with endometriosis having difficulty conceiving. While the endometrium grows where it shouldn’t, it maintains its hormonal activity. During menstruation, it sheds the tissue. And, this can cause problems.
Types of endometriosis
Depending on the form and location, there are three types of endometriosis:
- Superficial: Also called peritoneal endometriosis, this is where the endometrial tissue settles in the most superficial part of the ovaries and peritoneum. It presents with reddish lesions and over time, forms small scars.
- Ovarian: Here small cysts are seen in the ovaries. These are also known as “chocolate cysts” due to their appearance. Sometimes they form adhesions with nearby tissues like the fallopian tubes and peritoneum.
- Deep: This is the most complex form and has serious consequences for the woman’s health. It is characterized by small endometriotic nodules in the deepest layers of the peritoneum and pelvic cavity. In addition, this can compromise the kidneys, ureter, bladder, and other areas.
There’s no exact cause that explains why endometriosis appears. But, there are several hypotheses that try to explain its origin. Some of the most widely accepted ones are:
- Metaplasia: Suggests that the endometrium has the ability to replace other tissues of the pelvic region.
- Vascular transplantation: Speaks of the possibility of fragments of the endometrium being displaced and implanting in areas far away, traveling through blood vessels and lymphatic vessels.
- Retrograde menstruation: Happens when the covering of the uterus flows out, through the Fallopian tubes and towards the abdomen, instead of being expelled during menstruation. The tissue is deposited in the pelvic organs and grows.
The above theories have been accepted as possible causes. However, there are also other risk factors associated with endometriosis.
- Genetic predisposition
- Family history
- Starting menstruation at an early age
- Frequent periods, lasting 7 days or longer
- Anatomical alterations in the genital area
- Previous surgery on the uterus
- Not having children
An inability or difficulty conceiving is one of the most common signs of endometriosis. However, because of the hormonal imbalance it implies, it also leads to problems like:
- Abdominal, before and after menstruation
- Cramps for a week or two before and after menstruation
- During and after sex
- In the lower back
- With bowel movements
- Long menstruation
- Bleeding between periods
When a doctor suspects the condition due to endometriosis symptoms, she will begin the diagnosis by doing a physical exam. Then she may confirm with tests such as: transvaginal ultrasound, MRI, or pelvic laparoscopy.
There are different treatment options available for endometriosis. The options depend on factors such as: age, desire of the patient to get pregnant, symptoms (and seriousness), location, and extension.
The goal of treatment is focused on relieving endometriosis symptoms, removing lesions, and restoring the women’s fertility (if she wishes).
Treatment may include medication. This could be over-the-counter or prescription pain relievers, contraceptive pills, progesterone injections or pills, or specialized medication. Surgery is reserved for only the most serious cases. And surgery can range from conservative to complete.
In addition to treatment, the patient should improve their eating habits and practice exercise and relaxation. While they are no cure, they will help control endometriosis symptoms.