What is endometriosis and how do you treat it?

Endometriosis affects an estimated 5 million women of reproductive age in the United States. It happens when the tissue that lines the uterus, (the endometrial lining), grows outside of the uterus. This usually occurs in the pelvic area; on the ovaries, the lining of the pelvic cavity or the fallopian tubes.

Because these growths are made of endometrial tissue, they respond the same way that the lining of the uterus does during the menstrual cycle. Each month they build up tissue and then slough it off during menstruation. But in the case of these growths, this can result in internal bleeding, inflammation, cysts, and scar tissue in the affected areas.

The most common symptoms of this condition are: extreme pelvic pain around menstruation and/or ovulation, excessive menstrual flow, pain during sexual intercourse, fatigue, lower back pain with menstruation, and infertility.

The predominant theory as to how this condition develops proposes that some part of the endometrium backs up through the fallopian tubes and implants itself in the surrounding pelvic area, where it then begins to grow. It is suggested that immune and/or hormonal problems are what allow the tissue to take root and grow.

For a definitive diagnosis, it is essential for a woman to see her doctor or health care provider. S/he will perform what is called a laparoscopy. Under anesthesia, the abdomen is distended with gas. A small scope, about the diameter of a drinking straw equipped with several lenses and a light, is inserted into the abdomen so that the doctor is able to visually examine the abdomen for any endometrial growths. This way the doctor can locate any growths and also determine their size. She may use this opportunity to remove growths.

Treatments for endometriosis include the total removal of the uterus and ovaries, the removal of spots of endometriosis with laser surgery, or hormonal treatment of the condition. Hormonal treatment acts to block ovulation and the hormonal stimulation of endometrial tissue. For this reason some women choose oral contraceptives as a first step in addressing symptoms. A limited, yet simple treatment for the pelvic pain that results from endometriosis, is also a common treatment for menstrual cramping, non-steroidal anti-inflammatory drugs (NSAIDs for short). NSAIDs, such as Motrin or Ibuprofen halt the production of prostagladins, which are the source of many menstrual symptoms, including cramping.

If a woman is diagnosed with endometriosis, there are now a number of research institutions and support groups available, both on and off line.

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