ENDOMETRIOSIS

 Basic information

description

The inner lining of the uterus (called the endometrium) is made up of endometrial tissue. This tissue normally builds up during the menstrual cycle. It is then shed each month during the normal menstrual period. Endometriosis occurs when this tissue grows outside the uterus in places such as the fallopian tubes or the ovaries. Rarely, the tissue may grow in other areas of the body. The disorder can affect females between puberty and menopause. The average age is between 25 to 29. There may be no symptoms.

FREQUENT SIGNS & SYMPTOMS

• Symptoms may begin suddenly or develop over years.
• Pelvic pain that may occur at anytime. It may increase during menstrual periods, especially the last days.
• Pain with sexual intercourse.
• Premenstrual spotting, blood in the urine, or blood in the stool (sometimes).
• Back pain.
• Infertility.

causes

• Unknown. Different theories exist and include
  • Menstrual tissue backs up through the fallopian tubes into the abdomen, where it implants and grows.
  • Genetic, or certain families have risk factors.
  • It is an autoimmune disorder.
  • Endometrial cells spread via blood or lymph vessels.
  • Cells in the abdomen change into endometrial cells.
  • Environmental factors may be involved.

risk increases with

• Never giving birth or delaying childbirth.
• Women with family history of endometriosis.
• Medical conditions that involve the cervix or vagina.

PREVENTIVE MEASURES

There are no specific preventive steps.

expected outcomes

It is an ongoing, long-term disorder that may get worse until menopause (when it usually stops). Symptoms can be relieved with treatment. Women with severe disease may have less success with treatment. The ability to become pregnant depends on factors such as severity of the disorder and success of treatment.

possible complications

• Infertility.
• Severe pain that causes depression, stress, and problems with daily living activities.
• Adhesions (scar tissue) of pelvic organs.
• Endometriosis can recur after treatment.
• Cysts and pelvic masses called endometriomas.
• An increased risk of cancer is a possibility.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and a pelvic exam. Medical tests may include laparoscopy. A thin, lighted tube (called a laparoscope) is inserted through a small incision (cut) in the abdomen to view internal organs and to sometimes remove tissue. Open surgery (laparotomy) may be needed for diagnosis.
• Treatment may include drug therapy, surgery, or both. Alternative treatments (such as acupuncture) may help. Treatment will vary depending on the severity of the disease and the patient's age and desire for pregnancy. A patient may desire pregnancy now, at a later time, or not at all.
• Different procedures are used for treatment. The options will be explained to you. A hysterectomy may be suggested for women who do not desire pregnancy.
• Use a heating pad or take warm baths to relieve pain. Cold therapy may help. Use ice packs on the abdomen.
• Put a pillow under your knees when you rest or sleep. When lying on your side, pull the knees up to the chest.
• To learn more: Endometriosis Association, 8585 N. 76th Place, Milwaukee, WI 53223; (800) 992-3636; website: www.endometriosisassn.org.

medications

• You may use nonprescription drugs, such as nonsteroidal anti-inflammatory drugs, to relieve minor pain.
• Stronger pain relievers may be prescribed.
• Hormonal drugs to stop ovulation may be prescribed.

activity

• Exercise, such as walking, helps to relieve pain.
• You may be taught to do Kegel exercises to help strengthen the pelvic floor muscles.

diet

Some women have pain relief with diet changes. Ask your health care provider about recommendations.

 notify our office if

• You or a family member has endometriosis symptoms.
• Severe pain occurs, or other symptoms recur.
• Pregnancy does not occur after trying for 1 year.

Special Notes: