Endometriosis

What is Endometriosis? Endometriosis is a disease that affects 1 in every 10 women in the United States. It is defined as a disorder in which tissue that normally lines the uterus (endometrium), is grown outside of the uterus. It…

What is Endometriosis?

Endometriosis is a disease that affects 1 in every 10 women in the United States. It is defined as a disorder in which tissue that normally lines the uterus (endometrium), is grown outside of the uterus. It is associated with monthly menstrual cycles, during which a patient can experience such symptoms as heavy periods, prolonged bleeding, pelvic pain, abnormally painful cramps and pain upon sexual intercourse.

Estimated to affect over 176 million women worldwide, endometriosis has a tremendous impact economically. Business loses billions of dollars each year due to the loss in productivity and work time that women can put into their job, strictly due to the emotional and physiological symptoms that endometriosis can cause. On top of this, endometriosis has been linked to many other health concerns, including infertility, autoimmune diseases and certain cancers, including uterine and ovarian cancer.

Despite its large threat to the field of women’s health, it is remarkable to see that out of the 32.3 billion dollar budget the National Institutes of Health (NIH) received in 2017, only 0.03% of that was dedicated to research in the field of endometriosis. The same occurred in 2016.

What causes endometriosis?

While there is no known exact cause of endometriosis, many researchers have purposed the theory of retrograde menstruation to have an impact. During normal menstruation, the female womb naturally sheds off it's lining, the endometrium. According to the theory of retrograde menstruation, some of this endometrial tissue sloughs off from the uterus and moves backward through the fallopian tubes and spreads throughout the pelvic cavity. This can include organs such as the ovaries, rectum, ureter, bowels, etc.

Once implanted, these endometriosis lesions will have their own “mini-periods” in coordination with the woman’s normal menstrual cycle. This can cause more endometriosis tissue to slough off and continue to spread throughout the body.

What are the symptoms of endometriosis?

Endometriosis can present itself through a variety of symptoms that can vary for every woman. However, the most common symptoms of endometriosis cases are listed below: Painful menstrual cramps (dysmenorrhea) Heavy or painful menstrual bleeding (menorrhagia) Pelvic pain Gastrointestinal pain and discomfort during menstrual periods Pain during or after sex (dyspareunia) Painful bowel movements or urination during menstrual periods Infertility Neuropathy in the form of leg or lower back pain Fatigue and Aching Masked symptoms/no symptoms at all

How is Endometriosis Diagnosed?

The only way to formally diagnose endometriosis is through laparoscopic excision of a believed endometriosis lesion, followed up with a pathology report. Laparoscopy is a surgical procedure that inserts a laparoscope (light and camera) into the abdomen to visualize the abdominal and pelvic anatomy for treatment and diagnostic purposes. There are also many diagnostic tools that endometriosis specialists use to obtain a presumptive diagnosis, along with the extent to which the disease has spread and the possible symptoms that most likely go along with it. This can include such basic means as a comprehensive pelvic examination to more complex imaging tests such as intravaginal sonography or an MRI.

How is endometriosis treated?

How is endometriosis treated? While there is no definitive cure for endometriosis, physicians and researchers have worked tirelessly to find ways to relieve patient symptoms and traces of the disease. In order to control patient symptoms, doctors have generally prescribed pain medications and birth control pills amongst many other pre-surgical measures. While these medications vary on their effectiveness for every woman, they are strictly used to monitor and control symptoms, not to treat the disease itself.

In more severe cases of endometriosis, laparoscopic surgery may be advised. Different surgeons have different techniques when it comes to removing endometriosis adhesions. However, the “gold standard” for surgically removing these lesions is through laparoscopic deep-excision surgery. Using this technique, a highly skilled surgeon can excise (cut out) any believed lesion, both carefully and fully, allowing a comprehensive biopsy sample to be obtained. This is important to note as other methods of removal, such as fulguration and laser ablation, simply destroy the lesion, which means a pathology report cannot be made and the risk of harming surrounding healthy tissue is increased.