ENDOMETRIOSIS
About Endometriosis
Causes & Symptoms
UNDERSTANDING ENDOMETRIOSIS
Millions of women across the world are affected by endometriosis and approximately 10% of women in the UK of childbearing age may have the condition.
It is the second most prevalent gynaecological disorder after uterine fibroids and symptoms range from mild discomfort to debilitating pelvic pain. Many women with the condition find their lives severely disrupted including their work, education and social lives. Endometriosis may affect family relationships with partners, friends, children and colleagues and it may also cause difficulties in becoming pregnant.
Women in the UK of childbearing age may have the condition
Women with Infertility have endometriosis
CAUSES OF ENDOMETRIOSIS
Endometriosis is a condition that affects millions of women around the world. It occurs when tissue similar to the lining of the uterus, the endometrium (En-do-mee-tree-um), grows outside the uterus, typically in the pelvis.
While the exact causes of endometriosis are not fully understood, there are several proposed theories for its development.
One theory suggests that retrograde menstruation plays a role in endometriosis. Normally, during menstruation, the lining of the womb sheds and exits the body through the vagina. However, in retrograde menstruation, some of the menstrual blood containing endometrial cells flows backward into the fallopian tubes and into the pelvic cavity. These displaced cells can then attach to organs and tissues in the pelvis, leading to the development of endometriosis.
Another theory suggests that genetic factors may be involved. It is believed that certain genes may make some women more susceptible to developing endometriosis. If a close female relative, such as a mother or sister, has the condition, the risk of developing endometriosis may be higher.
Hormones, particularly oestrogen, also play a significant role in endometriosis. Oestrogen is responsible for stimulating the growth and shedding of the uterine lining during the menstrual cycle. It is thought that abnormal oestrogen levels or an imbalance of hormones could contribute to the development of endometriosis. This is supported by the fact that endometriosis tends to occur in women of reproductive age, when hormone levels fluctuate the most.
Another theory proposes that immune system dysfunction and inflammation may contribute to the development of endometriosis. The immune system is responsible for recognising and eliminating abnormal cells or tissues in the body. In women with endometriosis, the immune system may not effectively clear the displaced endometrial cells, allowing them to grow and cause inflammation.
While these are some of the proposed causes of endometriosis, it it likely that multiple factors play a role. More research is needed to fully understand the exact causes and mechanisms behind endometriosis and in the UK there are currently a number of on going studies looking at treatments and management of endometriosis.
SYMPTOMS OF ENDOMETRIOSIS
Approximately 10% of women suffer from endometriosis. While some women may have no obvious symptoms or signs of the disease, many will have one or more of the following:
One common symptom of endometriosis is pelvic pain. This pain can range from mild to severe and may be present before or during menstruation, during intercourse, or during bowel movements or urination. The pain may feel like cramps or a constant, dull ache in the pelvic region.
Many women with endometriosis also experience heavy or irregular menstrual periods. This can mean having periods that last longer than usual, experiencing very heavy bleeding, or having periods that are closer together or further apart than the typical 28-day cycle.
Another symptom is pain during intercourse, known as dyspareunia (dys-par-ay-oo-nee-a). This pain can range from mild discomfort to severe pain, and it may be felt deep in the pelvis or at the entrance of the vagina.
Some women with endometriosis may also experience bowel symptoms which include bloating, constipation, diarrhoea, or nausea, particularly around the time of their menstrual period but by no means exclusively.
In addition to these common symptoms, endometriosis can sometimes cause infertility. It is estimated that around 50% of women who have difficulty getting pregnant could have endometriosis. The exact mechanisms behind this are not fully understood, but the presence of endometriosis can interfere with the normal function of the reproductive organs and causes organs to stick together.
It’s important to remember that not all women with endometriosis will experience the same symptoms, and some may have no symptoms at all. If you suspect you may have endometriosis or are experiencing any of these symptoms, please contact us to arrange a consultation.
WHY DOES ENDOMETRIOSIS CAUSE PROBLEMS?
Endometriosis can vary in severity and may impact different aspects of a woman’s life.
One common problem is chronic pain. The abnormal growth of endometrial tissue in areas such as the pelvis, ovaries, or fallopian tubes can lead to persistent pain. This pain can be debilitating and may affect daily activities, work, and relationships. Women with endometriosis often experience intense pelvic pain before or during menstruation, during intercourse, or during bowel movements or urination.
Another problem is difficulty conceiving. Endometriosis can interfere with the normal function of the reproductive organs, making it difficult for some women to conceive. The presence of endometrial tissue outside the uterus can lead to the formation of scar tissue, adhesions, or ovarian cysts, which can affect egg release, fertilisation, or implantation.
Endometriosis can also have a significant emotional impact. Dealing with chronic pain, fertility challenges, and the uncertainty of the condition can be emotionally draining. Women with endometriosis may experience feelings of frustration, sadness, or anxiety. It’s important to seek emotional support and talk to healthcare professionals who can provide guidance and resources.
Additionally, endometriosis can have an impact on daily life. The pain and discomfort associated with the condition may lead to missed work or school days, decreased productivity, or difficulty participating in social activities. Fatigue and low energy levels are common due to the physical strain of the condition.
Common Problems
Endometriosis Causes
ADHESIONS
Adhesions, are bands of scar tissue that can form inside the body. Scar tissue is the body’s way of healing itself after an injury or surgery. When adhesions develop, they can cause organs or tissues that are normally separate to stick together. Think of it like glue binding things together inside your body. These adhesions can form between organs in the abdomen, such as the intestines, ovaries, Fallopian tubes, the uterus or between organs and the inner lining of the abdomen/pelvis.
Adhesions can be problematic because they can restrict the movement or normal functioning of organs.
ENDOMETRIOMATA
Ovarian endometriosis can develop from inside the ovaries or develop on its surface. An endometrioma is an ovarian cyst with endometriosis in its lining. Endometriomas are often filled with bloody fluid and cause pain by cyst growth and pressure on the surrounding structures. Endometrioma cysts rarely occur without endometriosis elsewhere in the pelvis.
Endometriomas can make the ovaries very enlarged and can affect fertility as well as the accessibilty of the ovaries in patient undergoing IVF or egg freezing.
TISSUE INVASION
Endometriosis can invade bowel, bladder, ureters, vagina and diaphragm and directly inflame and irritate the organ which is invaded. this leads to organ-specific symptoms such as painful bowel movements, bloody and painful urination, vaginal spotting and right chest and shoulder pain.