Endometriosis (Endo)

Endometriosis (from endo, "inside", and metra, "womb") is a gynecological medical condition in which endometrial-like cells appear and flourish in areas outside the uterine cavity, most commonly on the ovaries. The uterine cavity is lined by endometrial cells, which are under the influence of female hormones. These endometrial-like cells in areas outside the uterus (endometriosis) are influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms often worsen with the menstrual cycle.

Endometriosis is estrogen dependent and typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 5-10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations.

The natural behavior of the endometrium is to respond to hormones produced in the body, particularly estrogen, during each menstrual cycle. The endometrium builds up to a thick, blood vessel-rich, glandular layer in preparation for pregnancy. When pregnancy does not occur then the endometrium sheds this blood and results in a period.

A similar reaction takes place in the stray cells that have found their way into the pelvic cavity. Each month they respond to hormones, and break down and bleed, but the blood and tissue shed from these endometrial growths have no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from these sites, and leads to inflammation. It also can result in the gradual growth or worsening of the endometriosis.

Many women start to suspect something is wrong when the amount of pain they feel with their periods worsens. For other women the disease may not throw up any noticeable symptoms, but they may be having problems with their fertility and are not successful in conceiving. It is then that they seek medical advice which could lead to further investigation.

As endometriosis can lead to anatomical distorsions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury), the causality may be easy to understand; however, the link between infertility and endometriosis remains enigmatic when the extent of endometriosis is limited. It has been suggested that endometriotic lesions release factors which are detrimental to embryos, or, alternatively, endometriosis may more likely develop in women who fail to conceive for other reasons and thus be a secondary phenomenon.

DIAGNOSING ENDOMETRIOSIS

Physical examination
A pelvic examination involves the physician feeling and looking for abnormalities that are associated with endometriosis. Physical findings depend on the severity and location of the disease. There may be palpable nodules or tenderness in the pelvic region, enlarged ovaries, a tipped-back (retro-displaced) uterus, or lesions on the vagina or on surgical scars.

Laparoscopy
A laparoscopy is an exploratory procedure that allows the physician to see inside the pelvic region to observe and check for endometrial growths. The procedure involves making a small incision near the navel and inserting a laparoscope (a long, thin, lighted instrument) into the abdomen. The abdomen is distended with carbon dioxide gas to make it easier to see the abdominal organs. Usually, the endometrial growths can easily be seen. Because Endometriosis implants or growths vary in appearance and can be mistaken for other conditions, the lesions should be surgically removed and examined under a microscope to confirm the presence of the disease.

Imaging tests
Imaging tests (e.g. pelvic ultrasound, magnetic resonance imaging) may be used to identify individual endometrial lesions, but they are not used to determine the extent of the disease. The implants are not easily identified using this method.

Biochemical markers
There has been extensive investigation of a membrane antigen called CA-125 in women with Endometriosis. Several reports suggest that levels of CA-125 are elevated in women with Endometriosis, particularly those in the advanced stages of the disease. A recent study of this antigen level, showed it to be high in 90 percent of women with Endometriosis. Possible diagnosis with a blood test to check levels of CA-125 could be used to check for Endometriosis.


LINKS
Wikipedia
About
Endometriosis.org

Endo Resolved

Theendometriosisassociation
ERC


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