Endometriosis
Why does the presence of Endometriosis cause pelvic pain?
Each month, when a woman gets her period the lining of the uterus (which is called the endometrium) breaks down and is shed as menstrual flow. When a woman has endometriosis, the kind of tissue that makes up the lining of the uterus also shows up in other parts of her body, including the ovaries, the bowels, and the bladder. During her period, this tissue breaks down — but since it is outside the uterus, it can't leave the body during menstruation, and cysts and scar tissue may form as a result. The presence of adhesions in the pelvic area make the pelvic organs rather fixed. Any motion of these organs (e.g., during intercourse), could produce pelvic pain.
Do women with more severe menstrual cramps have a greater tendency to acquire Endometriosis?
Although one of the most common characteristics of women with endometriosis is severe menstrual cramps, this appears to be the result of the disease rather than a precursor to it.
What are the signs and symptoms?
The following symptoms are common with Endometriosis:
- painful periods
- pain between periods
- lower abdominal pain
- lower back pain
- painful intercourse especially with deep penetration (dyspareunia)
- menstrual irregularity
- infertility
- nausea, vomiting, dizziness and fainting
- pain with bowel movements and/or urination
If I put off having children until my 30s or later, do I have a greater chance of getting Endometriosis? Is there any truth to the belief that delayed childbirth can lead to Endometriosis?
It was earlier believed that early childbearing offered protection against endometriosis. Although the incidence of endometriosis is higher in women who delay having their first child, this may be because of the fact that endometriosis causes infertility. It is therefore difficult to distinguish whether the infertility preceded or followed the endometriosis.
Does endometriosis always cause infertility?
No, it doesn't. Probably fewer than 40% of women with endometriosis are infertile. However, women with endometriosis make up a large percentage of infertility patients.
Can I have Endometriosis without having any symptoms?
This does occur in some patients. The symptoms of endometriosis are highly variable. For instance, a patient with very extensive endometriosis may be incapacitated with pain or have very few symptoms. The same variability can be seen in mild endometriosis. Therefore, if the classic symptoms and signs and the physical findings of endometriosis are present in a patient, the diagnosis obviously could be straightforward. However, the absence of symptoms or physical findings does not mean that endometriosis is not present. Infertility is, at times, the only symptom.
I have pelvic pain all the time. What is the possibility that I have Endometriosis?
Usually, the pain associated with endometriosis is right before or during the menstrual period in the initial stages; however, as the disease progresses, it may occur throughout the cycle. The pain may be acute or chronic. In about half of the patients with severe or extensive endometriosis, the pain is chronic all through the cycle which gets worse right before and during menstruation, and during or shortly after intercourse.
Is it true that intercourse during the menstrual cycle increases the risk of Endometriosis?
This has not been proved. It has been suggested that intercourse during menses might increase tubal activity and increase the backflow of the menstrual cycle through the tubes and thus increase the risk of endometriosis. However, there are no statistics to bear this out.
Is there a relationship between Endometriosis and the use of tampons?
This is unlikely. Scientifically, there has not been any basis to conclude that the use of tampons increases the risk of developing endometriosis. Also, with regard to other hygienic practices (such as douching after the menstrual period), it has not been shown that this increases the risk of endometriosis.
Can Endometriosis be prevented?
There is no current manner of preventing Endometriosis, and it is not a disease which is "contracted" or "caused" by anything the patient did - nor is it contagious. It is, however, highly suspected to be genetic.
What is Endometriosis?
Endometriosis occurs when endometriotic tissue is found growing outside the uterine lining (endometrium). Growth of endometiotic tissue may appear in many places in the pelvis, attached to organs such as the ovaries, fallopian tubes, bladder, bowel etc…
Symptoms of Endometriosis:
Pain is often the number one symptom of endometriosis, though severity may vary from person to person. Other symptoms to look out for include:
- Heavy or irregular periods
- Bloating and gastrointestinal problems (in connection with menstruation)
- Fatigue, sleeplessness and depression
- Infertility and recurrent miscarriage
What are the treatment options?
In women who want to retain their reproductive potential, surgical treatment tends to be conservative, with the goal of removing endometriotic tissue and preserving the ovaries without damaging normal tissue. Women who do not wish to maintain their reproductive potential, removal of the ovaries and/or hysterectomy may be the option.
Pelvic pain during periods is not normal?
