March 19th, 2004
By Louis Wittig :eCureMe Staff Writer
March 18th, 2004 : Physician Approved
It’s one of the most common gynecological diseases - estimated to affect
10% to 15% of women in their child-bearing years - and it can lead to
infertility and in extreme cases, radical surgery: endometriosis. Though serious,
endometriosis can often occur without symptoms - making it all the more important
for women who are considering having children to keep the term in mind at their next
Also known in medical shorthand as "endo", endometriosis afflicts at least
5.5 million women in North America. Any woman who’s ovulating - from her
first period to menopause - is at risk. The disorder is directly linked to
women’s monthly cycles - specifically changes in the lining of the uterus.
A specialized tissue - called the endometrium - covers the inner surface of
the uterus. Every thirty or so days, a cycle of hormones signals the endometriosis
to thicken, anticipating the possibility of pregnancy. When no pregnancy occurs and
hormone levels drop, the thickened lining that’s built up on the endometriosis
breaks down and exits the body through the vagina.
Occasionally, however, bits of the endometrium tissue that’s designed to work
in the uterus are found in other parts of a woman’s reproductive system, pelvis
or abdominal structures. These patches are known as implants, lesions or nodules.
Scientists don’t yet know exactly how or why they develop outside the uterus
(most often the it occurs on the ovaries, fallopian tubes, tissues surrounding the
uterus, bowels and bladders - in extreme cases, endo patches can grow on distant
parts of the body - such as lungs). Some theories hold that the origins are
genetic, while others focus on the immune system or estrogen in causing the disorder.
Go to ’Endometriosis’ Page]
The problem these growths cause is that, even outside the uterus, they continue to
thicken and breakdown each month as they receive hormonal signals. Since the natural
exit isn’t available for the menstrual material generated by the nodules,
it builds up and can come to irritate the tissue around it. This build up can, in
turn, cause cysts and scarring, as well as adhesions - anomalous tissues that
connect two normally unconnected organs.
In the short term, the most common symptom of endometriosis is pelvic or abdominal
pain. The pain can be chronic, or can be pronounced around specific events -
such as menstruation, urination, bowel movements or sex. Other symptoms include
intestinal pain, heavy periods and spotting between periods. In some cases women
with endometriosis don’t experience any pain. Scarring on the ovaries or
fallopian tubes can lead to infertility; 30% to 40% of women who have the disease
are unable to conceive.
Recent research has also found that women who suffer from endometriosis are at
increased risk for a host of other diseases: rheumatoid arthritis, multiple
sclerosis, chronic fatigue syndrome, fibromylagia (recurring muscular pain), allergies
Diagnosis & Treatment
If there is any upside to endometriosis, it’s that aside from the potential
for infertility, researchers haven’t attributed any serious long-term
effects to it. No cure is available, but a number of treatment options are and
diagnosis isn’t difficult.
The only way for doctors to be sure that endo is at the root of a woman’s
symptoms is to literally see it. Commonly, patients who are suspected of having
endometriosis undergo ultrasound and magnetic resonance imaging (MRI) procedures
that produce images of the pelvic organs and allow physicians to spot large areas
of the misplaced tissue. Confirmation can be obtained through a more invasive
procedure - laparoscopy. Laparoscopy involves a surgeon inserting small tube
that holds a light and a camera (a laparoscope) into the body through a small incision
in the abdomen. The laparoscope allows the surgeon to see any endo growths on internal
Depending on the severity of the pain, one of three (or a combination of several)
treatment options is possible. The use of medication - from relatively weak
over-the-counter pills to strong prescription medications - can be
effective in controlling mild pain. Hormone therapy is also possible. As the progress
of the disease is related to the hormonal signals the endometrium receives, altering
those signals - by taking drugs that regulate or block the flow of certain
hormones throughout the body - can decrease or stop completely a woman’s
menstrual cycle. As long as the cycle is held in check, so are the symptoms.
When the disease is widespread, and / or the pain is severe - surgery may be
necessary. The first surgical option is an extension of the diagnostic process.
After using the laparoscope to see the growths, surgeons may use a second tube
mounted with lasers or small surgical tools to either remove the unhealthy tissue or
use intense heat to seal off the surrounding blood vessels which keep it alive. The
alternative, laparotomy, is only used in extreme cases. Performing a laparotomy
involves removing the entire uterus - and if the damage is extensive enough -
the ovaries and fallopian tubes as well.
While such major consequences are rare, the fact that they occur at all speaks to the
pain and complication that endometriosis can cause. Keeping aware of the disease is
the first step in keeping ahead of it.
Contact Louis Wittig at louis@eCureMe.com
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