What is endometriosis?
Endometriosis is a condition caused by the presence of endometrial tissue outside of the uterus. Between 5 and 10% of the female population suffer from this condition, although it often goes undiagnosed.
The most common symptom of endometriosis is painful periods, although in some cases women may experience pain throughout the cycle. Intercourse might also be painful, and, in more severe cases in which the rectum or bladder are affected, the individual may have intestinal or urinary issues.
One of the main concerns of patients with endometriosis is how it’s related to infertility: 30% to 50% of women affected by endometriosis will have fertility issues, and 35% to 50% of infertile women are diagnosed with endometriosis.
Causes of endometriosis and treatment
The causes are still unknown, although there are several theories. The most common theory is retrograde menstruation: this is when the endometrial cells that are shed during a woman’s period travel backwards through the fallopian tubes towards the pelvis where they will attach instead of travelling out of the body.
Other theories also exist, such as the theory that endometrial cells are transported by blood vessels or the lymphatic system, or that peritoneal cells are transformed into endometrial cells.
Treatment will depend on the patient’s symptoms, progression of the condition and whether or not the woman wants to conceive at that time. It is primarily focused on controlling symptoms and, above all, alleviating pain. When the cysts caused by endometriosis are large or the pain severely restricts daily activities, surgery is sometimes necessary.
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Frequently asked questions about endometriosis
Experts do not know why some women develop endometriosis. During each menstrual period, most of the uterine lining and blood is shed through the cervix and eliminated through the vagina. However, some of this tissue can enter the pelvis through the fallopian tubes. Women who develop endometriosis may simply be unable to eliminate these cells from the pelvis.
Endometriosis cannot be diagnosed solely based on symptoms. Your physician may suspect endometriosis if you have fertility issues, intense menstrual cramping, pain during intercourse or chronic pelvic pain. It may also be suspected if you have a persistent ovarian cyst. Endometriosis is often found among other close family members, like a mother or sister. Remember, however, that many women with endometriosis have no symptoms at all.
This condition can affect women who have already had children and it can also affect adolescents and young adults. Some experts claim that endometriosis is more likely in women who have never been pregnant. Endometriosis can be found in 24% to 50% of women who suffer from infertility and in over 20% of women who experience chronic pelvic pain.
There is a genetic component, but it is a multifactorial condition and no specific genetic link has been established.
Endometriosis is a chronic illness. We can alleviate the pain and limit its progression, but it can only be cured by the arrival of menopause.
Endometriosis is classified into one of four stages (I-minimal, II-mild, III-moderate, and IV-severe), depending on the location, spread and depth of the endometrial implants, presence and severity of adhesions, and presence and size of ovarian endometriomas. Most women have minimal or mild endometriosis which are characterised by superficial implants and mild adhesions. Moderate and severe endometriosis are characterised by chocolate cysts and more severe adhesions. The stage of endometriosis does not correspond to the presence or severity of symptoms; infertility is very likely with stage IV endometriosis.
The stages of endometriosis are not related to a woman’s chances of conceiving. There are women with very mild cases who are not able to conceive naturally, and vice versa.
The presence of endometrial tissue may lead to abnormalities that complicate correct fallopian tube functioning in addition to impacting the quantity and quality of a female’s eggs, as well as the processes of fertilization and embryo implantation. These complications directly impact our fertility.