Endometriosis – Causes, Symptoms and Treatment

Endometriosis is a problem affecting a woman's uterus - the place where a baby grows when she's pregnant. Endometriosis is when the kind of tissue that normally lines the uterus grows somewhere else. It can grow on the ovaries, behind the uterus or on the bowels or bladder. Rarely, it grows in other parts of the body.

Symptoms of Endometriosis

Dysmenorrhea - Painful, sometimes disabling menstrual cramps; pain may get worse over time (progressive pain)

Chronic pelvic pain - typically accompanied by lower back pain and/or abdominal pain.

Dyspareunia - Painful sex

Dyschezia - Painful bowel movements

Nausea, vomiting, and/or diarrhea

If a girl notices these symptoms, it doesn't necessarily mean that she has endometriosis. Lots of other things — like an infection — may cause similar symptoms. But it's important to see a doctor right away if you notice these symptoms. If you haven't been examined by a gynecologist for the first time yet, this is a good time.

What causes endometriosis?

Experts do not know what causes endometrial tissue to grow outside your uterus. But they do know that the female hormone estrogen makes the problem worse. Women have high levels of estrogen during their childbearing years. It is during these years-usually from their teens into their 40s-that women have endometriosis. Estrogen levels drop when menstrual periods stop (menopause).

Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. (This process is termed coelomic metaplasia.)

The endometrium is at its thinnest immediately following menstruation and thickens during the first 2 weeks of your menstrual cycle as a result of increasing levels of the hormone progesterone.

Diagnosing endometriosis

There is no simple test that can be used to diagnose endometriosis. In fact, the only reliable way to definitively diagnose endometriosis is by performing a laparoscopy and to take a biopsy of the tissue. This is what is known as "the golden standard".

However, this is an expensive, invasive proceduce. Furthermore, if the surgeon is not a specialist in endometriosis s/he may not recognise the disease, which can result in a "negative" diagnosis.

CA125 Test is a blood test that checks levels of a blood protein known as CA125, which is a tumor marker for certain gynecological cancers, but is also used to detect a specific protein found in the blood of women who have endometriosis. However, it is important to note that CA125 levels also may be increased during pregnancy, menstruation and in the presence of other non-cancerous gynecologic diseases or cancers.

Endometriosis - Treatment

Endometriosis symptoms, no pregnancy plans

If you have endometrial pain or bleeding and no immediate plans to become pregnant, birth control hormones (patch, pills, or ring) or anti-inflammatories (NSAIDs) may be all that you need to control pain. Birth control hormones help shrink endometrial tissue and reduce pain for most women.

Hormonal therapy using progesterone medications are another effective treatment for endometriosis. Progesterone pills or injections can be used. However, side effects can be a problem for some women. The possible side effects include depression, weight gain, and spotting of blood.

Anti-gonadotropin drugs such as Synarel and Depo Lupron prevent the ovary from producing estrogen. Potential side effects of these drugs include menopausal symptoms (such as hot flashes), vaginal dryness, mood changes, and early loss of calcium from the bones.