Endometriosis


Endometriosis is a painful disease in which the uterine lining moves outside the womb and grows in other parts of the body. I was diagnosed with Endometriosis in 2003 but found that I had the disease since my early teens. Far too many doctors still believe that endometriosis is rare in teenagers and young women; I can undoubtedly prove them wrong. Consequently, they do not consider a diagnosis of endometriosis when teenagers and young women come to them complaining of symptoms like period pain, pelvic pain and painful intercourse. The realization that endometriosis could be found in teenagers and young women came about as a result of research by the national endometriosis support groups. Thankfully the research caught the attention of some eminent gynecologist in the 1990s. So , teenagers and young women in their early 20s are not too young to have endometriosis.

Endometriosis is an abnormal gynecological condition characterized by ectopic growth and function of the endometrial tissue. Precise incident of the disease is unknown, but evidence of it is found in approximately 15% of women who undergo pelvic laparotomy for other indications. The average age of women found to have endometriosis is 37 years. Pregnancy may have an influence in preventing or ameliorating the disease. The causes of endometriosis are unknown; evidence suggest that ectopic endometrium of endometriosis develops from vestigial tissue of the wolffian or mullerian duct; other evidence strongly suggest that fragments of the endometrium from the lining of the uterus are refluxed during menstruation backward through the fallopian tubes into the peritoneal cavity, where they attach, grow and function (Mosby 2006).
Whether or not endometriosis should be considered a preneoplastic disease represents a major and controversial issue. Studies on the epithelial lining of cystic ovarian endometriosis have documented the presence of metaplastic, hyperplastic or atypical changes whose prevalence in endometriosis is not defined. Differences in the studies may be due, at least in part, to a different study population and/or selection biases. Moreover the presence of neoplasm per se might induce metaplasia in the adjacent endometriosis. Overall, there is insufficient evidence supporting metaplasia of endometriotic lesions as a preneoplastic condition (E JOURNAL April 2006-cancer).

Endometriosis can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. Other common sites include uterosacral ligaments, the cul-de-sac, the pouch of Douglas, and the rectal-vaginal septum. In addition, it can be found in caesarian-section scars, laparscopy or laparotomy scars, and on the bladder, bowel, intestines, colon, appendix, and rectum. But these locations are not so common. In even more rare cases, endometriosis has been found in the vagina, inside the bladder, on the skin, even in the lung, spine and brain (endometriosis.org). My endometriosis was found along my spinal cord which I still have problems with today.

Many women from earlier times believed in many superstitions of endometriosis, they believed that pregnancy cures endometriosis. Unfortunately I was told this by my Grandmother. Today technology has proved this myth wrong. They also believed that Endometriosis causes infertility; again with five children I can tell you this myth is also wrong. Many women with endometriosis do go on to have children. Gynecologist generally believes that 60-70% of women with endometriosis are fertile. Furthermore they say that about half the women who have difficulties do eventually conceive with or without treatment.
The challenge of endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces chronic inflammatory reaction. Doctors check for endometrial tissue by inserting a thin viewing tube thorough a small incision near the navel also known as laparoscopy. If they find endometriosis cells they then administer drugs to slow to relieve pain and slow the growth of the misplaced tissue. Surgery to remove the tissue may be done but may provide only temporary relief because the tissue may grow back, unless the ovaries are removed as well (Women’s Health Issues: Merck Manual Home Edition).

The cause of endometriosis remains unknown. A treatment which fully cures endometriosis has yet to be developed, and there is no overwhelming medical evidence to support one specific type of treatment for endometriosis over any other. Choosing a treatment therefore comes down to the individual woman’s needs, depending on her symptoms, her age, and her fertility wishes. She should discuss these with her physician so they, together, can determine which long term, holistic, treatment plan is best for her individual needs. For many women, this can be a combination of more than one treatment over longer periods of time. Pain is the most common symptom for many women with endometriosis so therefore they are prescribed different pain killers such as: simple analgesics, compound analgesics, mild narcotics, narcotic analgesics, and non-steroidal anti-inflammatory drugs. Hormonal Therapies are also used since endometriosis is exacerbated by estrogen. Therefore, hormonal treatment for endometriosis is designed to attempt to temper estrogen production in a woman’s body such as treatments may subsequently relieve her symptoms. Laparoscopic surgery is the only definitive way to diagnose endometriosis. In many cases the disease can be diagnosed and treated in the same procedure. There are also Nutritional and Complementary therapies and a multi-disciplinary approach (ESHRE guideline for the diagnosis and management of endometriosis).

So knowing what myself and women across the world know now, I recommend all women become educated about this silent but nasty disease. The more you know the better off you and your children are. Many women with this disease have found that talking to others with this disease have helped them learn from their experiences, understand treatments and coping methods, and just get an overall better understanding of endometriosis. By working together across national borders support groups have become a powerful and effective force, and hoping one day to further awareness move research forward.

Endometriosis week is an annual event that gives women with endometriosis a real focus to raise awareness nationally and in your local communities, and provides an opportunity to raise funds for research. Endometriosis Awareness Week in Europe, Australia and South America is 3-9 March 2009, and in the United States it is for the entire month of March (Endometriosis awareness 2008).

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