About Endometriosis
What is Endometriosis?
Endometriosis is a condition in which cells that are normally found inside the uterus (endometrial cells) are found growing outside of the uterus. That is, the lining of the inside of the uterus is found outside of it. The uterine cavity is lined with endometrial cells, which are under the influence of female hormones. Endometrial cells are the cells that shed every month during menstruation, and so endometriosis is most likely to affect women during their childbearing years. The cellular growth is not cancerous, but benign. Though there are not always symptoms, it can be painful and lead to other problems. The lining of the uterus consists of a type of tissue called endometrium - composed of endometrial cells - that thickens each month to prepare for an egg. It is here where an egg cell implants and grows if it is fertilized. If an egg is not fertilized, the endometrium breaks down and exits the body during the menstrual period.
Endometrial cells that grow outside of the uterus are called implants. These implants are found usually on the ovaries, fallopian tubes, outer wall of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. However, these implants follow the same pattern as the endometrium lining the uterus of getting thicker, breaking down, and bleeding. Problems occur because these growths are outside of the uterus, and the blood cannot flow out of the body. This can lead to the formation of scar tissue and cysts as well as difficulties getting pregnant.
Endometrial cells that grow outside of the uterus are called implants. These implants are found usually on the ovaries, fallopian tubes, outer wall of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. However, these implants follow the same pattern as the endometrium lining the uterus of getting thicker, breaking down, and bleeding. Problems occur because these growths are outside of the uterus, and the blood cannot flow out of the body. This can lead to the formation of scar tissue and cysts as well as difficulties getting pregnant.
Who gets affected by Endometriosis?
Almost any female between puberty and menopause is susceptible to the onset of endometriosis. Younger girls in their mid-teens also have an increased incidence of endometriosis. Similarly, endometriosis has also been found in peri and post-menopausal women. However, endometriosis is relatively rare in this group. It would seem that endometriosis is more likely to occur in females through their 20s and into their 30s. Women who delay their childbearing would seem to be more susceptible, although young women can still develop quite severe forms of endometriosis. Stress factors play a part and contraceptive history may be important. Pregnancy may disrupt the course of endometriosis, although not cure it in all patients. However, women who have had children are somewhat less likely to have endometriosis, although it is by no means rare in patients who have had perhaps one or two children.
Patients who are particularly likely to have endometriosis are those with the onset of increasing period pain where this has not been a particular problem in the past. Patients who are developing new pain on intercourse or vague, unexplained abdominal pain, which may be unrelated to either intercourse or periods, may also have endometriosis.
Endometriosis can sometimes be associated with period dysfunction and irregularity. Sometimes patients may present with symptoms of pain or pressure due to endometriotic cysts in the ovaries.
The classic association with endometriosis is, of course, infertility. Most patients with infertility are now laparoscoped, specifically to look for evidence of tubal damage and to check for endometriosis.
Gynaecologists need to be aware that the incidence of endometriosis is increasing as more patients defer their childbearing. Therefore, young women under the age of 40 who present with infertility or abnormal gynaecological symptoms, such as pain, bleeding, dyspareunia (pain on intercourse), or dysmenorrhoea need active investigation to exclude the possibility of developing endometriosis.
Patients who are particularly likely to have endometriosis are those with the onset of increasing period pain where this has not been a particular problem in the past. Patients who are developing new pain on intercourse or vague, unexplained abdominal pain, which may be unrelated to either intercourse or periods, may also have endometriosis.
Endometriosis can sometimes be associated with period dysfunction and irregularity. Sometimes patients may present with symptoms of pain or pressure due to endometriotic cysts in the ovaries.
The classic association with endometriosis is, of course, infertility. Most patients with infertility are now laparoscoped, specifically to look for evidence of tubal damage and to check for endometriosis.
Gynaecologists need to be aware that the incidence of endometriosis is increasing as more patients defer their childbearing. Therefore, young women under the age of 40 who present with infertility or abnormal gynaecological symptoms, such as pain, bleeding, dyspareunia (pain on intercourse), or dysmenorrhoea need active investigation to exclude the possibility of developing endometriosis.